Dear Jeannie: Cheaters and Alcoholics

Dear Jeannie,

My love interest is in a serious relationship with his long time girlfriend. They love each other, but he thinks his relationship (and his girlfriend) are preventing him from being "free". How would he rationalize cheating on his girlfriend (who he does love) with multiple women? How would his girlfriend rationalize staying with her boyfriend despite his indiscretions?

Torn in Tokyo


Dear Torn,

In my experience with clients who have done this very thing, men don't need a whole lot to rationalize. They can compartmentalize a relationship, and believe to their core that they love one women with all their heart (including having children with her), yet can be sexually involved with others b/c it's "just sex." You didn't mention if he cheats all out or not, but he could rationalize that she doesn't meet all his needs or that she makes him feel trapped with talk of marriage. He can escape his current life circumstances with these other women.

Now your guy's girlfriend is who I'm worried about. If she is rationalizing staying with him, she's in that to-be-pitied place many women find themselves in...stuck with an emotionally (or physically) abusive partner and unable/unwilling to leave. Arguably, her staying with someone like your love interest would be codependency in action. I did a post here about the top 10 reasons why a woman wouldn't leave a situation similar to what you're describing. Maybe it'll help you out some, as well as this post, which is on dependent personality disorder, which can be misconstrued as codependency.


Dear Jeannie,

My main character is a recovering alcoholic--in high school. He's been in AA for over a year, avoiding old friends/habits and trying to stay busy. He's a very social kid, which was what got him into trouble in the first place. How likely is he to lie to friends (or strangers) about his sobriety struggles? What weakness might take him by surprise and tempt him back toward bad behavior?

Sober in Summerville


Dear Sober,

High schoolers are high schoolers, even if following the 12 steps of AA. They aren't the most mature of individuals, though a year of sobriety is nothing to sneeze at. Most addicts I have worked with (who attend AA or NA programs) are very up front about their addiction, as honesty is highly valued within the organizations. You have to be honest with yourself first, admitting you have a problem. This is Step One, and it also reads in the Big Book (for AA) that admitting you have a problem to others enforces the issue. You'll have to decide if you want him to secretly practice sobriety or not, but in reality, those in secret rarely are successful.

As to what weakness might take him by surprise and tempt him back toward using...definitely a love interest. I've seen it happen a few times just in the past few years. When an old flame--still in the throes of addiction--beckons their finger, the sober person tries to help them, and in the process slips up. They might even chalk their involvement with the person up to Step 9 (making direct, personal amends whenever possible), but usually that's a front. Hope that gives you something to think about.

Got Questions?

Post them anonymously below, using monikers like Sleepless in Seattle.
I'll get to them in future Dear Jeannie columns.

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 problem...so 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.

T3 - Alcoholism...Disease or No?

Recently, I was reading over at a post about alcoholism at the Philosophy of KLo. The gist of it was asking whether alcoholism is really a disease or not. Well, I had to jump in on the discussion!

There are definitely people who drink moderately. Let's call them the Mods. Many of them can look at an alcoholic and think, "Have a little control. Be more responsible," or "STEP AWAY FROM THE BEER." Why? Because the Mods are able to drink moderately, having made the decision--conscientiously--not to drink to excess. I'd venture a guess that most of the people in the "Alcoholism is NOT a disease" camp are probably Mods or Complete Abstainers. And you can see their point, right? The camp motto might be, "You control your actions."

And there is something to be said for this idea...especially for beginning alcoholics. Certainly, the initial use of alcohol is voluntary, but once addiction takes hold, those in the camp that alcholism IS a disease (therapists, doctors) believe this initial control is disrupted.

We adhere to the medical model of addiction. There is a biological predisposition some people have that influence them in whatever environment they grow up in. Studies of twins, separated at birth, show them to have higher likelihood for both having an addiction than would be expected if there weren't some genetic component.

The official National Institute on Alcohol Abuse and Alcoholism position is that "alcoholism is a disease. The craving that an alcoholic feels for alcohol can be as strong as the need for food or water. An alcoholic will continue to drink despite serious family, health, or legal problems. Like many other diseases, alcoholism is chronic, meaning that it lasts a person's lifetime; it usually follows a predictable course; and it has symptoms. The risk for developing alcoholism is influenced both by a person's genes and by his or her lifestyle." Go here for a complete, word-by-word breakdown of the NIAAA's definition of alcoholism.

A person who is dependent on alcohol can't process rational cues that Mods might try to tell them about responsibility and control. They don't even process cues from their own bodies, as evidenced by people who drink knowing they are killing themselves with cirrhosis of the liver. Alcoholism is progressive, which is another mark of a disease (think cancer). It gets worse and worse. This level of drinking, despite all the negative consequences, indicates that something is distinctly different in their brain...AND THIS NEVER SHUTS OFF.

People who go to AA meetings will tell you that they are alcoholics. They introduce themselves that way at meetings even when they've been sober for twenty years. The desire is still there to drink! It's a constant struggle they fight every day to win. They will say they are never "cured," but are "recovering." If they relapse, they blame it on their disease, and the fact that relapse is a part of recovery (which it is). But at this point, as a therapist, I tell the client that the disease model is NOT a crutch to further their addiction or an excuse for irresponsibility. (So there is a fine line!)

As a Christian, I recognize the power of Christ in someone's life. I've known people who can literally put down a cigarette or beer after being saved and never pick it up again. This would lend some credence to the "Not a Disease" camp. But studies have been shown that people who reach the stage of "alcoholism" can never go back to being a Mod. So I'm betting even these miraculous "healings" come at the price of never again drinking the tiniest sip, for fear of the disease taking over once again.

I could go on...and I might in a later post...but for now, I'm curious what your thoughts are after reading some of the above stuff. Do you think its a disease or not?

Treatment Tuesday - Alcohol Dependence

Photo by Sheep"R"Us'

Today’s character therapy assessment comes courtesy of Eric. He’s writing in about his character Roberta*. Roberta is a homeless woman living out of her car on the streets of Denver with her two children. She’s a 24-year-old Hispanic who has been an alcoholic for the past six years or so. Her drink of choice is tequila, which she pretty much drinks every night until she passes out. She feels she is worthless, has a severe confidence problem, loves her children more than anything, but has just about lost all hope.

* Names have been changed to protect the fictional.

In the mental health field, there is quite a difference between substance abuse and substance dependence. Alcohol abuse would be drinking in situations where is it physically hazardous (i.e., driving), having recurrent legal problems for drinking (DUIs), and drinking so much that you fail to fulfill major role obligations at work, school or home. The person would also continue to use despite social/interpersonal problems that are exacerbated by the drinking.

Alcohol dependence is marked by much stronger characteristics, such as tolerance (needing increased amounts of alcohol to achieve the desired intoxication effect), withdrawal symptoms (i.e., sweating, increased heart rate, hand tremors, insomnia, nausea/vomiting, anxiety, fleeting hallucinations or illusions that can be visual, auditory or tactile, and physical motor agitation (i.e., restless, jittery legs).

It’ll be important to add these elements into your characterization of Roberta to make her a believable alcoholic. In addition, people with a substance dependence also take in larger amounts than intended, have a persistent desire and make unsuccessful efforts to cut back. A great deal of her time would be spent in activities necessary to obtain, use, or recover from the effects of the alcohol. Social, occupational or recreational activities would be given up or reduced because of her drinking, and the she would continue drinking despite knowledge that a physical or psychological problem is caused or exacerbated by the substance.

As far as alcohol treatment would go (since you mentioned she would need to go to a facility for detoxifcation and treatment), I would definitely Google this. When I worked at a private psychiatric hospital, I’m pretty sure I remember the Registered Nurse on duty in the Alcohol and Drug unit telling me that alcohol is one substance where you need to be medically monitored while you detox. Something about how the body gets so adjusted to having the substance that without medical intervention, the body could go into shock and the person might die. (Since I’m not a medical professional…you might want to check with a doctor.)

Okay. On to Roberta’s emotional state. You mentioned that she feels worthless and has a severe confidence problem. Feelings of worthlessness usually originate from the family of origin. This is why I asked questions about Roberta’s dad and mother. (Thanks for filling in the blanks I asked in my additional email of questions!)

There are four classic attachment styles identified by John Bowlby. Roberta exemplifies the Ambivalent Attachment style. I recommend you (and anyone else) get the book, Attachments: Why You Love, Feel and Act the Way You Do by Dr. Tim Clinton and Dr. Gary Sibcy. This is a book written from the Christian perspective about attachments. Fascinating for character development. The following is from that book.

Roberta would likely believe/think the following:

1) She is not worthy of love.
2) She is not capable of getting the love she needs without being angry and clingy (although you didn’t specifically mention anger or clinginess…you might want to think about writing these in)
3) Others are capable of meeting her needs but might not do so because of her flaws. (which shows the confidence issue)
4) Others are trustworthy and reliable but might abandon her because of her worthlessness (which speaks directly to the heart of Roberta’s internal dialogue…her mom left, her dad ultimately left by drinking and driving, and her first husband left, as well).

Now we’re stepping into more generalizations, but people with this type of attachment style, therapists have seem some commonalities, such as:

• fear of making decisions,
• rarely expressing disagreement with others
• obsessed with the fear of being left alone (could apply with her children…scared they might get taken away from her, maybe?)
• feelings helpless when alone
• desperately seeking new relationships when others end (which could initially be a needy relationship with Frank when she meets him?)
• perpetually seeking advice
• frequently subordinating themselves to others
• often working below their ability level
• accepting unpleasant tasks to please others
• having a tendency to express distress through medically “unexplainable” physical symptoms rather than admitting to an emotional pain (i.e., headaches while doing something stressful rather than just owning up to the fact that the activity is stressful)
The one fact that might be problematic in this list is the subordinating quality. Hispanic women are not known for this. Even Hollywood portrays Hispanic women as strong and reliable (Jennifer Lopez, Gloria Estefan, Salma Hayek, Eva Longoria Parker, etc.). So consider how you might make this element more culturally acceptable if you decide to include it.

Alright! That’ll do it for today. If you’ve kept with me this long, you’re to be commended. Eric, I hope this helps!

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@hotmail.com.