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Silent Voices – ending the silence on parental problem alcohol use

by Marion Rackard, IAHIP, ACI

“I am 65 years of age and still carry the scars of my childhood surrounded by alcohol.”  

“The hardest part was the never-ending repeated sense of crushing disappointment when one of my parents was drunk again. In one way, I came to expect it but it never stopped being disappointing or painful; there’s always a small amount of hope that you cling on to when you have a parent with alcoholism.”

“When our parents drank, we were left to our own devices. From a very early age, we had to assume total responsibility to feed ourselves, manage finances, manage chaotic parents, get to school.”

These testimonies - from people who grew up in homes where one or both parents drank to excess - give voice to the trauma that such an experience can have, lasting long into adulthood and causing untold damage.

There is now a wealth of research that tells us growing up in a home where a parent has a problem with alcohol is an adverse childhood experience (ACE) that can have devastating consequences, disrupting the child’s development, severing a family’s emotional bonds and giving rise to lifelong implications for physical and mental health (Felitti et al., 1998; Ashton et al., 2016; Beliis et al., 2014). In Ireland, independent research finds that up to one in six children live in a home with parental problem alcohol use. This demonstrates that it is a whole of population concern that spans all social classes.

In real terms, one in six means it is likely that more than 200,000 children in Ireland are living with the traumatic circumstances of a childhood where parental problem alcohol use is a frequent event. It is further estimated that there are around 400,000 people in Ireland today who are adult children of alcohol-impacted families. Taken together that is 600,000 people – 12% of the population.

Silent Voices  

Given the huge numbers of people being harmed from this preventable trauma, Alcohol Action Ireland (AAI), the national independent advocate for reducing alcohol harm, has in recent years begun campaigning on the issue and in January 2019 launched the Silent Voices initiative (Alcohol Action Ireland, 2019). It has been fostered by three individuals who experienced parental problem alcohol use – Carol Fawsitt, Barbara Whelan and this article’s author, Marion Rackard.

Silent Voices aims to break the silence by highlighting the figures and research – and people’s personal stories. Awareness needs to be raised among a wide range of audiences from the public, to politicians, to the media, educators and anyone who works with vulnerable children and families. Fergal Keane (BBC Africa Editor and Author) was the guest speaker at the launch of Silent Voices and spoke about his experience with the issue (Alcohol Action Ireland, 2021a).

Since the initiative launched AAI has:

• Established a platform, Shared Voices, where adult children can share their experiences anonymously. Recently two of these stories were animated (Alcohol Action Ireland, 2021b) which gives an illustration of some of the trauma experienced. If you have clients who might wish to share their stories anonymously on the platform this can be done at the website https:// alcoholireland.ie/silent-voices/shared-voices/.
• Held workshops and meetings with a range of interested organisations and individuals. From this we developed our manifesto of strategic actions (Alcohol Action Ireland, 2021c) needed to address the issues in this area.
• Carried out public talks to raise awareness within the therapeutic community, such as an Aware talk (Alcohol Action Ireland, 2021d) given by co-founder Barbara Whelan and two others (Alcohol Action Ireland, 2021e) given by co-founder Marion Rackard (IAHIP, ACI) and addiction counsellor Austin Prior.
• Collaborated with academics from University College Cork to explore the experiences of ACOAs as indicated in the Shared Voices and with other interviewees.
• Expanded this research work into a detailed paper around education (Alcohol Action Ireland, 2021f).
• Met with senior government ministers and policy makers.
• Advocated for the introduction of better data sharing between police and schools to provide immediate support for children who have experienced domestic violence.
• Garnered significant media coverage of this issue with over 100 items in national and regional media as well as the dedicated Silent Voices social media handle and launched a podcast (Alcohol Action Ireland, 2021g) featuring the founders of the initiative discussing the campaign.

However, despite all of this, much more needs to be done. As well as grassroots and NGO work, Government should provide funding so that all agencies that work with children and families become trauma-informed. This would mean that professionals in front-line services and counsellors are adequately equipped to deal with the issues that stem from adversity in childhood and can recognise children affected by parental problem alcohol use.

Educators, too, are very well placed to identify children experiencing hidden harm. The provision of specific training in relation to adverse children experiences (ACEs) should be examined at teacher training level, and at all levels of professional development – from teachers to principals to education welfare officers.

Silent Voices would also like to see robust, comprehensive and consistent data gathered in appropriate settings, for example in mental health, child and family, education, homeless and criminal justice settings. This will identify the numbers of children and adults affected by this issue and will inform policy and service provision. Public discourse/debate on the right to a childhood free from alcohol harm should take place, and children should have their voices heard in relation to the impact of alcohol on their lives.

Covid impact

This issue has become even more pressing since the Covid pandemic lockdowns of the past year and a half. We know that Ireland’s alcohol users substituted most of their drinking from regulated licensed premises to consumption in the home. And we know that homes with children have seen an increase in at-home drinking with data from the Central Statistics Office showing that 27 per cent of households with children reported an increase in alcohol consumption (CSO, 2020). A survey carried out by Mental Health Ireland also found that one in five parents home schooling said their alcohol consumption has increased during Covid-19 (Mental Health Ireland, 2021).

Couple this with reports that in 2020, there was an 87% increase in the number of domestic violence cases dealt with by the Director of Public Prosecutions (DPP) and we can see the very real dangers facing children and families (RTE, 2021). 

Although alcohol should not be used an excuse for a perpetrator of domestic abuse, research clearly shows that domestic abuse is higher among women whose partners consume alcohol (Wilson et al., 2017) and that alcohol use increases the occurrence and severity of domestic violence (Graham et al., 2011).

Tackling the issue

Knowing all of this, there must be responses at all levels of society. We know with ambitious thinking and leadership, change can happen. For example, our nearest neighbours Scotland have a national training plan in place to ensure that all frontline workers can recognise and deal with psychological trauma (NHS, 2019). Police, social workers and nurses were among the staff to benefit from the plan, which is being rolled out to all frontline workers.

AAI knows from contact with services that all kinds of professionals, at all levels, are crying out for training on this issue and for more cross-agency collaboration. Not everyone needs to be an expert or be able to provide a response, but people want to know how to recognise trauma and help children and adult children heal from the wounds of past or current traumas.

Personal experience

As an IAHIP member and supervisor, I have encountered adult children of parental problem alcohol use as clients with varied presentations: depression; anxiety; relationship conflicts/breakdown; parenting worries; obsessive-compulsive disorder; substance use; eating disorders. All of these conditions highlight an undertone of buried shame; fear; hurt; rejection; loneliness; grief. As someone who grew up with parental problem alcohol use myself and having experienced therapy myself for many years, I have regularly felt that this group of clients was largely ignored in the research literature and certainly within counselling trainings. This is why I became a co-founder of Silent Voices.

Parental problem alcohol/drug use impacts on family communications and interactions determining the quality of relationships which shapes the contours of each member’s life. It often brings a heavy pain and burden, resulting in hurt, confusion and grief that can consume the human soul across generations, as can be seen in the quotes at the start of this article.

I look forward to joining with colleagues who share a similar interest in the adult/child impact of this subject in contributing to this journal and other outlets on a range of topics, which will shine a light on the struggles and challenges faced by this group. Please contact us if you are a therapist who is interested in providing counselling to this group of clients. We are interested in having contact with therapists working with these clients to build capacity and deepen understanding of the range of impacts and the counselling interventions that are of most benefit.

Upcoming public event on 18 October 2021 with Dr Stephanie Brown, internationally recognised expert on the treatment of alcoholics, adult children of alcoholics and all addicts and their families, based on her research defining a developmental process of active addiction and recovery. Podcast with Dr Brown for therapists also to be released prior to the event.

Web                        alcoholireland.ie/campaigns/silent-voices/

email                        silentvoices@alcoholactionireland.ie (marionrackard7@gmail.com)

Social media            @IrelandSilent (Twitter) 

Marion Rackard ACI, IAHIP. Supervisor works in private practice in Naas, Co.Kildare. Also part time Project Manager for the HSE Alcohol Programme and the  www.askaboutalcohol.ie campaign. Marionrackard7@gmail.com

References

Alcohol Action Ireland (2021a). Silent Voices, Fergal Keane https://www.youtube.com/watch?v=GVL-2YuoZoI

Alcohol Action Ireland (2021b). Silent Voices, Shared Voices https://alcoholireland.ie/silent-voices/shared-voices/ Alcohol Action Ireland (2021c). Silent Voices,

https://alcoholireland.ie/wpfb-file/silent-voices-manifesto-pdf/ Alcohol Action Ireland (2021d). Silent Voices, https://alcoholireland.ie/silent-voices/pathways-to-recovery/ Alcohol Action Ireland (2021e). Silent Voices, Resources https://alcoholireland.ie/silent-voices/resources/ Alcohol Action Ireland (2021f).

https://alcoholireland.ie/wpfb-file/final-parental-problem-alcohol-use-and-education-pdf/ Alcohol Action Ireland (2021g). https://alcoholireland.ie/about/the-alcohol-file/

Ashton, K., Bellis, M. & Hughes, K.E. (2016) Adverse childhood experiences and their association with health-harming behaviours and mental wellbeing in the Welsh adult population: a national cross-sectional survey. The Lancet, Vol.388, Supplement 2, p.S21. https://doi.org/10.1016/S01406736(16)32257-7.

Bellis, M. A., Hughes, K., Leckenby, N., Jones, L., Baban, A., Kachaeva, M.& Terzic, N. (2014). Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries. Bulletin of the World Health Organization, 92(9), 641–655.

doi:10.2471/BLT.13.12924

Central Statistics Office (2020). Social impact of Covid-19 Survey April 2020. https://www. cso.ie/en/releasesandpublications/ep/p-sic19/socialimpactofcovid-19surveyapril2020/ changesinconsumption/

Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACEs) study. American Journal Preventative Medicine. 14: 245-258;

Graham, K., Bernards, S., Wilsnack, S.C. & Gmel, G. (2011). Alcohol may not cause partner violence but it seems to make it worse: A cross national comparison of the relationship between alcohol and severity of partner violence. Journal of Interpersonal Violence. 26(8):15031523. doi:10.1177/0886260510370596

Mental Health Ireland (2021). Home Schooling Poll March 2021. https://www.mentalhealthireland.ie/ home-schooling-poll/

NHS (2019). Scottish psychological trauma training plan.https://www.nes.scot.nhs.uk/educationand-training/by-discipline/psychology/multiprofessional-psychology/national-trauma-trainingframework.aspx

RTE (2021). https://www.rte.ie/news/ireland/2020/1114/1178145-dpp-domestic-violence/

Wilson I., Graham K.& Taft A. (2017). Living the cycle of drinking and violence: A qualitative study of women’s experience of alcohol-related intimate partner violence. Drug and Alcohol Review, 36, 115-124 

(C) IAHIP 2021 - INSIDE OUT 94 - SUMMER 2021