Alcoholism as a way of dealing with emotions and transformation in relational family therapy
Barbara Simonič
University of Ljubljana, Faculty of Theology, SloveniaRobert Cvetek
University of Ljubljana, Faculty of Theology, SloveniaAbstract
Alcoholism, which is a major public health and social problem, can be viewed from several perspectives, as its occurrence is a multifaceted phenomenon in terms of its development (causes), effects, and maintenance. The Relational Family Therapy paradigm looks at alcoholism and its dynamics in relation to dysfunctional affect regulation. Dysfunctional affect regulation and the general inability to manage emotions are often mentioned in relation to the development and maintenance of alcohol addiction. The mechanism of affect regulation generally refers to internal processes that allow an individual to maintain their emotions to a degree that feels still bearable for them. According to these assumptions, alcoholics drink in order to cope with difficult emotions, either because they have more negative emotional states than others do, or because they lack the internal resources to cope with these negative emotions. For them, consuming alcohol is a series of repeated attempts to regulate heavy emotions, which often stem from painful past experiences. The process of Relational Family Therapy, therefore, as treatment of addiction, focuses on identifying and transforming the dysfunctional regulation of affect, which is behind addictive behavior. By means of action research methodology, this paper presents the approach of Relational Family Therapy in working with an alcoholic client, with an emphasis on the aspects of affect regulation. We show how the client’s alcohol use appeared as a dynamic of inappropriate regulation of a painful core affect. In the process of Relational Family Therapy, a more functional regulation of the core affect was established, thereby reducing symptomatic behavior (alcoholism) in the client.
Keywords:
addiction, alcohol, psychotherapy, affect regulation, familyReferences
American Psychiatric Association. (2013) Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). Washington: American Psychiatric Publishing.
DOI: https://doi.org/10.1176/appi.books.9780890425596
Google Scholar
Ashok, K. (2021) Neurobiology of Alcohol and the Brain. London: Academic Press.
Google Scholar
Caan, W. (2013) ‘Alcohol and the family’, Contemporary Social Science, 8(1), pp. 8-17.
DOI: https://doi.org/10.1080/21582041.2012.745594
Google Scholar
Cassell, C. and Johnson, P. (2006) ‘Action research: Explaining the diversity’, Human Relations, 59(6), pp.783-814.
DOI: https://doi.org/10.1177/0018726706067080
Google Scholar
Crespi, T.D., in Rueckert, Q.H. (2006) ‘Family therapy and children of alcoholics: Implications for continuing education and certification in substance abuse practice’, Journal of Child & Adolescent Substance Abuse, 15(3), pp. 33-44.
DOI: https://doi.org/10.1300/J029v15n03_03
Google Scholar
Cvetek, M., Repič Slavič, T., Poljak Lukek, S. and Cvetek, R. (2011) ‘Marital and family therapist’s action research in light of some research problems: A one-cycle example’, Contemporary Family Therapy, 33(1), pp. 49-60.
DOI: https://doi.org/10.1007/s10591-010-9139-x
Google Scholar
Cvetek, R., Cvetek, M. and Gostecnik, C. (2008) ‘Action research in the light of integrative practice of marital and family therapists and some other research problems’, European Journal for Qualitative Research in Psychotherapy, 2008(3), pp. 38-45.
Google Scholar
Dermody, S.S., Cheong, J. and Manuck, S. (2013) ‘An evaluation of the stress-negative affect model in explaining alcohol use: The role of components of negative affect and coping style’, Substance Use & Misuse, 48(4), pp. 297-308.
DOI: https://doi.org/10.3109/10826084.2012.761713
Google Scholar
Emery, N.N. and Simons, J.S. (2020) ‘The role of affect, emotion management, and attentional bias in young adult drinking: An experience sampling study’, Psychopharmacology, 237(5), pp. 1557-1575.
DOI: https://doi.org/10.1007/s00213-020-05480-5
Google Scholar
Erzar, T. (2007) Duševne motnje. Celje: Celjska Mohorjeva družba.
Google Scholar
Gold, M.S. and Adamec, C. (2010) The encyclopaedia of alcoholism and alcohol abuse. New York: Facts On File.
Google Scholar
Gostečnik, C. (2003) Srečal sem svojo družino II. Ljubljana: Brat Frančišek in Frančiškanski družinski inštitut.
Google Scholar
Gostečnik, C. (2011) Inovativna relacijska družinska terapija. Ljubljana: Brat Frančišek, Teološka fakulteta in Frančiškanski družinski inštitut.
Google Scholar
Gostečnik, C. (2017) Relational family therapy. New York: Routledge.
DOI: https://doi.org/10.4324/9781315542744
Google Scholar
Gostečnik, C., Repic, T., Cvetek, M. and Cvetek, R. (2010) ‘Hidden mission of the psyche in abuse and addiction’, Journal of Religion and Health , 49(3), pp. 361-76.
DOI: https://doi.org/10.1007/s10943-009-9264-8
Google Scholar
Jakubczyk, A., Trucco, E.M., Kopera, M., Kobyliński, P., Suszek, H., Fudalej, S., Brower, K.J. and Wojnar, M. (2018) ‘The association between impulsivity, emotion regulation, and symptoms of alcohol use disorder’, Journal of Substance Abuse Treatment, 2018(91), pp. 49-56.
DOI: https://doi.org/10.1016/j.jsat.2018.05.004
Google Scholar
Jerebic, D. and Jerebic, S. (2012) ‘Različni modeli zdravljenja odvisnosti in relacijska družinska terapija’, Bogoslovni vestnik, 72(2), pp. 297-309.
Google Scholar
Johannessen, A., Tevik, K., Engedal, K., Tjelta, T. and Helvik, A.S. (2022) ‘Family’ members experiences of their older relative’s alcohol and substance misuse’, International Journal of Qualitative Studies on Health & Well-Being, 17(1), pp. 1-10.
DOI: https://doi.org/10.1080/17482631.2022.2094059
Google Scholar
Khemiri, L., Franck, J. and Jayaram-Lindström, N. (2022) ‘Effect of alcohol use disorder family history on cognitive function’, Psychological Medicine, 52(4), pp. 757-769.
DOI: https://doi.org/10.1017/S003329172000238X
Google Scholar
Kober, H. (2014) ‘Emotion Regulation in Substance Use Disorders’ in Handbook of emotion regulation, 428-446.
Google Scholar
Koshy, E., Koshy, V. and Waterman, H. (2011) ‘What is action research?’ in Action research in healthcare (pp. 1-24). SAGE Publications Ltd,
DOI: https://doi.org/10.4135/9781446288696.n1
Google Scholar
Leonard, K.E. and Eiden, R.D. (2007) ‘Marital and family processes in the context of alcohol use and alcohol disorders’, Annual Review of Clinical Psychology, 3(1), pp. 285-310.
DOI: https://doi.org/10.1146/annurev.clinpsy.3.022806.091424
Google Scholar
Marshall, E.J. (2002) ‘Alcohol and society’ in Caan, W. and de Belleroche, J. (eds.) Drink, drugs and dependence: From science to clinical practice. London: Routledge, pp. 82-92.
Google Scholar
Mayshak, R., Curtis, A., Coomber, K., Tonner, L., Walker, A., Hyder, S., Liknaitzky, P. and Miller, P. (2022) ‘Alcohol-Involved Family and Domestic Violence Reported to Police in Australia’, Journal of Interpersonal Violence, 37(3-4), pp. 1-28.
DOI: https://doi.org/10.1177/0886260520928633
Google Scholar
McLaughlin, K.A., Gadermann, A.M., Hwang, I., … & Kessler, R.C. (2012) ‘Parent psychopathology and offspring mental disorders: Results from the WHO World Mental Health Surveys’, British Journal of Psychiatry, 200(4), pp. 290-299.
DOI: https://doi.org/10.1192/bjp.bp.111.101253
Google Scholar
Melrose, M.J. (2001) ‘Maximizing the rigor of action research: Why Would You Want To? How could you?.’, Field Methods, 13(2), pp. 160-180.
DOI: https://doi.org/10.1177/1525822X0101300203
Google Scholar
Mendenhall, T.J. and Doherty, W.J. (2005) ‘Action research methods in family therapy’ in Piercy, F. and Sprenkle, D. (eds.) Research Methods in Family Therapy. 2nd edn. New York: Guilford Press, pp. 100-118.
Google Scholar
Petit, G., Luminet, O., Maurage, F., Tecco, J., Lechantre, S., Ferauge, M., Gross, J.J. and de Timary, P. (2015) ‘Emotion regulation in alcohol dependence’, Alcoholism – Clinical & Experimental Research, 39(12), pp. 2471-2479.
DOI: https://doi.org/10.1111/acer.12914
Google Scholar
Pinsof, W.M., Zinbarg, R.E., Shimokawa, K., Latta, T.A., Goldsmith, J.Z., Knobloch-Fedders, L.M., Chambers, A.L. and Lebow, J.L. (2015) ‘Confirming, validating, and norming the factor structure of Systemic Therapy Inventory of Change initial and intersession’, Family Process, 54(3), pp. 464-484.
DOI: https://doi.org/10.1111/famp.12159
Google Scholar
Rangarajan, S. and Kelly, L. (2006) ‘Family communication patterns, family environment, and the impact of parental alcoholism on offspring self-esteem’, Journal of Social and Personal Relationships, 23(4), pp. 655-671.
DOI: https://doi.org/10.1177/0265407506065990
Google Scholar
Reingle Gonzalez, J.M. and Akers, T. A. (2017) ‘Transdisciplinary research perspective: epidemiological criminology as an emerging theoretical framework for substance abuse research’ in VanGeest, J.B., Johnson, T.P. and Alemagno, S. A. (eds.) Research methods in the study of substance abuse. New York: Springer, pp. 27-40.
DOI: https://doi.org/10.1007/978-3-319-55980-3_2
Google Scholar
Sayette, M.A. (2017) ‘The effects of alcohol on emotion in social drinkers’, Behaviour Research and Therapy, 2017(88), pp. 76-89.
DOI: https://doi.org/10.1016/j.brat.2016.06.005
Google Scholar
Schore, A.N. (2003) Affect regulation and the repair of the self. New York: W. W. Norton & Company.
Google Scholar
Sher, K.J. and Gerkin, E.R. (2007) ‘Alcohol and affect regulation’ in Gross, J.J. (ed.) Handbook of emotion regulation. New York: Guilford Press, pp. 560–580.
Google Scholar
Simonič, B., Poljanec, A. and Katona, M. (2013) ‘Alkoholizem kot mehanizem čustvene regulacije v družinskem sistemu in pristop relacijske družinske terapije v procesu okrevanja družine’, Anthropos, 45(3-4), pp. 269-283.
Google Scholar
Solis, J.M., Shadur, J.M., Burns, A.R. and Hussong, A.M. (2012) ‘Understanding the diverse needs of children whose parents abuse substances’, Current Drug Abuse Reviews, 5(2), pp. 135-147.
DOI: https://doi.org/10.2174/1874473711205020135
Google Scholar
Stern, D.N. (2004) The present moment in psychotherapy and everyday life. New York: W. W. Norton & Company.
Google Scholar
Styhre, A. and Sundgren, M. (2005) ‘Action research as experimentation’, Systemic Practice and Action Research, 18(1), pp. 53-65.
DOI: https://doi.org/10.1007/s11213-005-2459-3
Google Scholar
Urschel, H.C. (2009) Healing the Addicted Brain. Naperville: Sourcebooks, Inc.
Google Scholar
VanGeest, J.B., Johnson, T.P. and Alemagno, S.A. (2017) ‘History of substance abuse research in the United States’ in VanGeest, J.B., Johnson, T.P. and Alemagno, S. A. (eds.) Research methods in the study of substance abuse. New York: Springer, pp. 3-25.
DOI: https://doi.org/10.1007/978-3-319-55980-3_1
Google Scholar
Vernig, P.M. (2011) ‘Family roles in homes with alcohol-dependent parents: An evidence-based review’, Substance Use & Misuse, 46(4), pp. 535-542.
DOI: https://doi.org/10.3109/10826084.2010.501676
Google Scholar
Waterman, H., Tillen, D., Dickson, R. and de Koning, K. (2001) ‘Action research: a systematic review and guidance for assessment’, Health Technology Assessment, 5(23), pp. iii-157.
DOI: https://doi.org/10.3310/hta5230
Google Scholar
World Health Organization. (2016) International statistical classification of diseases and related health problems - 10th revision. 5th edn. Geneva: World Health Organization.
Google Scholar
Authors
Barbara SimoničBarbara Simonič, PhD, Full Professor, Faculty of Theology, University of Ljubljana, Slovenia
https://orcid.org/0000-0002-5842-2017
Authors
Robert CvetekRobert Cvetek, PhD, Full Professor, Faculty of Theology, University of Ljubljana, Slovenia
https://orcid.org/0000-0002-3048-9965
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