Ongoing Recovery for the Adult Child of an Alcoholic (ACoA) Therapist: Part 2

by Mick Devine

This article seeks to continue where the first article in the 2022 Summer edition of Inside Out left off (Devine, 2022). Having referred to the ‘symbiosis’ and ‘differentiation’ subphases of Margaret Mahler’s individuation process for the young child in that article, I will reflect on the ‘practising’ and ‘rapprochement’ subphases in this article. To remind the reader, my purpose for doing so is to support therapists in their work with clients who may be the adult child of an alcoholic (ACoA or ACA) by reflecting on how each subphase may have been impacted by a parent and how the other parent was also impacted by this alcoholism. I am particularly interested in supporting therapists with this client group who are themselves an adult child of an alcoholic, being one myself. This support might take the form of prompting the therapist to consider how being an adult child of an alcoholic is impacting your work with them and influencing how they present themselves as a client in your service and how understanding the presenting issues might be helped by being aware of the ACoA framework suggested in this article. This is referred to as “ACoA trauma syndrome” (Dayton, 2012, p.20). From among the legion of contributors to this topic I will seek guidance again from Margaret Mahler, Louise J Kaplan, AH Almaas, Tian Dayton and Stephanie Brown.

Practising Subphase
The ‘Separation Individuation’ process contains the simultaneous processes of the child separating from the mother while developing an individual identity (Mahler et al., 2000). The success of this process will depend on the quality of the attachment with the mother in the first place so that the child is secure enough to venture out into the world and back to the mother. The trust the child has in the mother is the trust he will have in the environment and in himself.

The ‘practising’ is practising separation from the mother. It is gradual and based on trial and error. Mahler’s ‘second birth’ of the ‘differentiation’ subphase is needed because the child is so attached to the mother that there is a ‘dual unity’. The success of this subphase is dependent on the quality of the attachment in the earlier phases.

There would be no need for a second birth if the infant’s total neediness and appetite for human attachment had not bound him into oneness with his mother in the first place.

(Kaplan, 1978, p.104)

Central to this practising period getting underway is the mother’s admiring eyes and celebrating the achievements of walking, getting stuff for mum, showing mum all that can be done. The mother is attuned to the child’s development. She is admiring and proud. This is communicated to the child and is essential encouragement to his continuing spirit of exploration.

The mother and father give the child their blessing. Their celebrating eyes exude confidence in the baby’s ability to make it out there: “look at you, my spectacular walking-away baby”. The baby gets the message and makes the most of his love affair with the world.

(Kaplan, 1978, p.162)

Mothers assist the toddler to walk alone. The view of the world is different, standing on their own feet, seeing a cat, toys, and a couch. The world looks very different to the child when she is on her feet. She can go away, transport herself independently. The world becomes her oyster. The child can climb on furniture and ascend to heights, get access to what was out of reach, get different perspectives on the world.

In the exhilaration of using his leg, chest, back and shoulder muscles all-out, the toddler is unconcerned about the numerous falls and bumps that are the unavoidable mishaps of an adventure.

(Kaplan, 1978, p.163)

The child knows elation. It is not an elation based on reality. The parents toddler-proof the house. Sharp objects are removed, pitfalls anticipated, stair gates and child locks installed, all the dangerous stuff and the valuable stuff is relocated at a height. The toddler is not aware that pitfalls are so plentiful and has no built-in sense of danger. He is not yet aware how precarious his elation is. The child still senses mum’s presence and has not got a sense that mum is separate. The idealism of his view of the world is an illusion and it depends on mum for it to be maintained. The mum, and dad, become stagehands. They make the dangerous environment safe for the child’s exploration and practising. There is an ‘optimal distance’ from the mother. At this distance the child can explore and function. If the distance is too short the child is not thriving and developing separation and independence. If the distance is too great the child’s confidence fails. The child is still dependent on the mother’s presence and while he is venturing away this is still in the environment of an ever-present mother that the child has not yet separated from.

If the mother is alcoholic, or co-dependent on an alcoholic, she may not be sufficiently attuned to this stage in the child’s development. If the admiring looks are not coming, the child’s courage fails him. If the mother’s absences are prolonged, the child’s developing sense of self will be stymied. The child needs the mother’s lap for emotional refuelling. If it is not reliably available, the child’s practising spirit will droop. If the environment is not made safe the child may have mishaps that dent pride in achievements. If the child’s exuberance is too stressful for the alcoholic or co-dependent, its environment may be too limited for a proper spirit of adventure to be satisfied.

Due to the anxiety and stress being caused by the parental addiction a spirit of adventure in the child is not facilitated. It is easier to exert control on the child and limit its opportunities for mishaps. Unfortunately, this also limits the scope for exploration and delight in developing new capacities. Even to learn from avoidable mishaps is valuable for the child’s learning about the environment and how to navigate it and to learn about their own developing capacities. The child gets the message that he is not ‘number one’ in the family. The environment is primarily set up to facilitate the needs of the alcoholic, not the needs of the child. If the mother does not return or is not available for emotional refuelling due to drunkenness, hangover, or preoccupied by a partner’s drinking, the child is left to their own devices to sustain a still fragile and emerging sense of self. This is demoralising and depressing for the child. For the child to enjoy at least partial success in the developmental task of separation from the parents, his needs and the response to them must be central to the task of being a family. In the alcoholic family this is not the case.

The alcoholic family is organised around the dominance and centrality of the parent’s needs - the alcoholic’s growing need for alcohol and the non-alcoholic’s need to control the alcoholic. Both parents are frequently overwhelmed by their own anxiety and need, and therefore, inattentive or marginally available to focus on the needs of the children. There is a chronic underlying fear held by all that things are, or soon will be, out of control.

(Brown,1988, p.139)

The child’s boundless energy can be inexhaustible and can wear mum and dad out in what is an already tired and stressed system. This may lead to frustration being vented on the child. Anger may be expressed if the child will not go to bed, go to sleep, sit still, not do risky things like climb on things or go beyond a boundary.

In the alcoholic family the alcohol is the central organising principle around which the family forms. As such the child can at best enjoy only partial success in this separation process.

The Impact of the Practising Subphase on Current Functioning and Relationships
So, the successful navigation of the developmental tasks to be tackled in this subphase will imprint the character for the lifespan. Reflective questions that evoke relevant traits might include the following: What is your spirit of adventure like? Do you seek out new things to do or do you do the same old things again and again? Do you like to learn? Do you like to go to new places? Do you like to meet 59 ISSUE 98 | AUTUMN 2022 new people and develop new friendships? Do you seek new jobs, careers, promotions, positions of leadership? How important is support from others for you to develop some of this? Can you go it alone or do you need the support of others? Do you have the support of others in your life?

Where a parent was alcohol dependent it is reasonable to expect the following shortcomings in the child’s developing personality. The development of self-confidence is impaired and the courage to explore and develop natural capacities stay dormant. The effects can be lasting. A courageous and confident sense of adventure may be lacking throughout the lifespan. The willingness to volunteer, put the self forward, take risks, be assertive, go into the unknown with curiosity may be lacking. There may be excessive caution and fear. There may be mistrust that people are unreliable, don’t have your back and are not there for you. This may lead to a spirit that is dampened down, and a sense that you are on your own and unsupported in life tasks. That it’s all up to you. There may be built in limitations to what you will explore or experience affecting you that you are not even aware of.

Tian Dayton speaks knowingly of this territory:

When a substance or compulsive behaviour rules family dynamics, family gravity gets thrown off kilter: …Kids learn to manoeuvre in and out of the parents’ moods which rule the atmosphere… they have to develop a premature independence… they can feel helpless and despondent, unable to do anything that can really lead to their family getting better, happier, or safer… they develop a sixth sense of when to hide, when to run, when to hurl themselves into the breach… They become little soldiers of fortune…

(Dayton, 2012, p.43)

In a primary relationship it might be worth wondering whether your relationships retained a spirit of doing new things or are they more characterised by boredom, repetition, monotony? Is it the same conversations, pastimes and hobbies, going to the pub, out for a meal, away for a weekend, TV programmes? Is what you say to each other and how you relate dominated by a set pattern and unexamined assumptions and beliefs about the other person or the relationship itself? Is intimacy still new and risky or are you afraid to show up in new and surprising ways? Do you put it all on the line? Is there loneliness and isolation in the relationships and a sense of emptiness and a vacuum?

Maybe in your parenting you might, or might not, still be patient and tolerant of mistakes and failures, even if it means you have to bear the cost, foot the bill or bail someone out.

What about you as a therapist? Was there a spirit of trying out new things on your therapy training programme? How important was your practising new skills? Was it monitored and scrutinised? Was it important that you had opportunities to learn in real life situations? Were you supported in trial and error, encouraged to take risks, make mistakes? Do you play safe in the therapy room? How open can you be about prizing your client and showing support and care and concern for their disasters and failures? Do you support the client to be at the edge trying new things and going out on a limb? Does your supervisor get excited about your ideas, desires and dreams?

Rapprochement Subphase
In this phase of development, the child goes back and forward. He leaves the mother’s lap to explore. He returns for emotional refuelling. Curiosity drives him out to explore. Fear drives him back to the lap. Over time, from 15 to 36 months, he will work out with his mum that he is separate from her and an individual in his own right. Mother is crucial in this. She is separating also. She is losing the dual unity too and the precious bonding that goes with parenting an infant. Her attunement to the child and his needs is crucial to the child’s freedom to succeed in the developmental task.

Up to now, in the child’s experience, mother did not have her own distinct presence. Mother was everywhere, she was the world. Now mother is being experienced as a person. The love affair between the two becomes more distinct. The child is aware of the mother. If she is there, he is fine. If she is not there, he is anxious at her loss. He relates to the mum. He can woo her. He can say ‘hi’ and ‘bye’. She plays along and is devoted to being relational. If she can’t be wooed, he can be dejected.

The circle of safety which once gave the child rein to measure his place in the world has lost its protective magic. Safety and wholeness now have more to do with the perplexing intangible space between the inner images of the self and the inner images of the mother than with the actual physical distance that separated them.

(Kaplan, 1978, p.192)

There will be wilfulness. There will be ‘No!’ There will be temper tantrums. This can be challenging for the parents. The child can be easily hurt and dejected and the temper is a way of fuming and fighting against desolation and restoring an inner balance. Mum and dad need to be tuned in to facilitate this. This wilfulness allows the child establish autonomy and his own power. It is important the will is not squashed. At the same time, it does not serve the child to always get its own way. The mother will also be saying ‘no’. She asserts herself and establishes her space. She may be acting on behalf of a younger sibling. The parents must demonstrate reasonableness. It is not good if the child feels it is all or nothing in its battles. The child establishes an inner psychological optimal distance. If the child emerges from this always having got its own way, there will be a feeling of fear of losing identity if he can’t control relationships. If he loses these battles the child will easily feel humiliated and self-doubting as an adult.

Where alcohol is the central organising principle around which the family forms, the stakes can be higher again with regard to expression of anger.

Anger is often the focal point around which issues of control, feelings, and the all-or-nothing frame are crystallised. For many ACAs, anger is dangerous… feeling it and expressing it will result in destroying the very individuals you would like to rely on;… anger threatens to repudiate denial of one’s own overwhelming deep neediness.

Brown, 1988, p.121)

For this process to succeed for the child, the child’s growth and development must be the priority for the family. If there is addiction and denial, then the addiction is the priority and not the child.

The back and forth of rapprochement will manifest in daily experiences of clinging and pushing away. The child will try to coerce the mother and get its own way. If the mother gives in too much, the child will fear the loss of itself and its immersion in the mother. If the mother resists the coercion, the child will feel left alone and abandoned. Over the course of the 20 months or so of this developmental process the child, on balance, will emerge with a cohesive sense of self. The constancy of the mother is crucial to this success. If there is alcoholism, the child is not the priority. This leaves the child with a precarious sense of self that is not based on self-worth and lacks a solid sense of its integrity with a realistic sense of will, power and ability to act in the world in a way that is seen to be effective and admirable.

This phase becomes a conflict. The child wants to go back and forward between the intimacy of the cuddle on the lap and the autonomy of independence, adventure and exploration. The child approaches the mother and the child avoids the mother. He wants the cuddle but he does not want to get stuck with the mother, needing her to the point that he can’t do without her. This threatens his emerging sense of self. Yet, if he avoids her for too long his grandiose sense of self gets deflated. The child finds an ‘optimal distance’ from mum. It’s not a resolution of the conflict, it is more a compromise that allows the child to function in the world and continue to develop a coherent sense of self.

Where this flexibility does not occur and compromise is not possible, as may well be the case in the alcoholic family, the child may emerge with a sense of, what Brown calls “dichotomous all-or-none thinking” (Brown, 1988, p.60). If there are no grey areas allowed the child must perceive the situation in a way that minimises ambiguity:

Within the dichotomous frame, individuals must cling relentlessly to their belief in themselves as bad in order to hold onto the illusion of attachment.

(Brown, 1988, p.109)

This is where the other parent starts to be a facilitative figure in this development. The father can be a bridge for the child into the world away from mum. They can go ‘outside’ together and explore the world away from mum in a safe way. The child can be on the dad’s shoulders and feel princely surveying the world. This emboldens the child in his adventure away from mum. The dad’s role in meeting the child’s ‘no’ helps the child navigate autonomy from mum. The intimacy with mum can be protected if it is the dad the child has the conflict with. Navigating the ‘no’ with dad is good preparation for life in the world. The separation is primarily from mum but there is separation from dad too. If dad is not available due to alcoholism or mum’s alcoholism, then he is not tuned into the child’s need. The child’s development is not the family priority. If the dad’s will is collapsed, or if his will is hard or macho, then the child is not served in his quest for his own will. If dad cannot handle temper tantrums and gives in to the child, the child has a grandiose sense of his power. If the child meets a stern and inflexible will from dad then the child’s will suffers.

The Impact of the Rapprochement Subphase on Current Functioning and Relationships
We emerge from the rapprochement subphase of this psychodynamic process with a more or less cohesive sense of our self, of our identity. It is this self we take into our life and into our relationships. This process will play a big part in determining the scope for satisfaction and contentment with ourself and our life. If our formation in this family of origin was influenced by alcoholism and its denial, then the impacts are significant and lasting and limiting:

The denial of alcoholism is a major organising principle structuring the family’s attachments, level of cognitive structural development, perceptions about reality, and related affect and the development of one’s personal identity.

(Brown, 1978, p.171)

Does your sense of your own identity allow you move back and forward in your relationships between autonomy and intimacy or do you have a preference? Do you get overwhelmed with intimacy and feel swallowed up and lost when you get close, or are close for longer than you want, feeling suffocated, frustrated and merged in the other's identity in a negative way? Do you prefer autonomy and independence to the point where you might become isolated and alienated and you remain in contact with others or stay connected with them too long?

When it comes to you as a parent, how has this identity formation impacted how you have parented children? The following from Brown may be true for you as a child, and perhaps even more so if there was alcoholism in your family, and may have some truth about the family you subsequently formed:

… the child constructs a personal identity that confirms beliefs about the self and others necessary to maintain attachment, facilitate identification, and maintain the family story, often all contrary to reality.

(Brown, 1978, p.169)

How is, or was, your parenting in relation to this rapprochement phase as the mum or as the dad? What factors established the optimal distance for your child to resolve or not resolve conflicts with you over anger, sadness or wilful power struggles? How well did this optimal distance allow the child to function and establish their own sense of cohesion? How constant a presence were you to facilitate their development of a cohesive sense of self? Where were the deficits and how do you see the lasting effects in your child’s personality today?

In your practice as a therapist, do you allow yourself become a distinct and idiosyncratic individual to your clients? What is the quality of your presence as the client experiments with ways of being? How are you in power struggles with client and supervisors? Do you have them, allow them, encourage them, seek them out? Are you scared of them, what might be risked or lost in terms of clients and income and supervisors and being alone and seen as ‘difficult’? Can you tolerate and allow a client’s sadness and despair and defeat and hopelessness and failure or do they trigger uncomfortable states in you of controlling and wanting to ‘fix’?

How does Recovery from this look?
Recovery from this begins with a recognition that such a reflection as is offered here touches a chord within the reader or contains a grain of truth (either for the reader themselves or their clients). Furthermore, there is a recognition that this formation still influences how the person accommodates herself to her current reality, and that her personality may have been formed to some extent by the family system she was part of then. Also there may be limitations built into the personal identity. This may be uncomfortable and unsettling. But there may also be curiosity to find out more or a desire to follow a thread that is being picked up. There can be recognition that the identity formation limits autonomy and individuation and is based on an incomplete separation from the parental figures and the family system:

Normally each individual has established a certain degree of separation as part of his ego structure. Experiences of more separation become a pressure and demand on his capacity to be separate. This will bring up old unresolved conflicts about separation, or simply exert a new but greater demand on his already existing capacity. Simply put, it will stretch his capacity for separation.

(Almaas, 1988, p.218)

Recovery might be a useful guiding principle; that something may have happened to me that I can recover from. Brown articulates this process in terms similar to those of Almaas and using the recovery metaphor:

ACAs realise they are still emotionally attached to their families of origin in self-destructive ways. They are bound by denial and by the beliefs about the family and themselves constructed to preserve these bonds. To change as adults, they must challenge the premises on which their core sense of identity has been constructed. Implicit in the entire process of recovery is the ultimate emotional separation from parents, whether alive or dead.

(Brown, 1978, p.263)

Tian Dayton (2012) quotes research by El-Geubaly et al. that accurately sets out the task for the ACoA:

ACAs inability to express their needs and feelings are based on ingrained patterns of distrust, secretiveness and fear of intimacy and abandonment and that the interpersonal difficulties of ACAs are reflective of the relational patterns in the alcoholic family of origin. Over time these patterns become the foundation for negative expectations about establishing and maintaining secure relationships.

(El-Geubaly et al., 1993, p.1410)

Following on from this then is the search for an environment where the exquisitely sensitive work of revisiting these phases of identity formation can happen, so as to gain insight and awareness. Can a trusting and supportive atmosphere be created where this formation process can be revisited? Can we experiment with dual unity, differentiation, practicing and rapprochement dimensions of our identity formation in a way that allows us to revisit these phases in a way that allows a crucible to form that is like a melting pot? What melts is the structures of our personality and core self-beliefs that form our identity. Perhaps that dissolution of personality will allow a greater degree of freedom and feeling more comfortable in our own skin. Something like what Dayton suggests here:

A special and protective space where we can not only be more than our ordinary selves,– generous, forgiving and high-minded – but less as well, where we can be vulnerable and shaky, stumbling over our faults and fears and have a hand outstretched as we ask for help in hoisting ourselves back up again.

(Dayton, 2012, p.236)

Conclusion
The work of personal growth can be precarious for all of us at the best of times and a stretch is needed to continue separation from unconscious attachments. This stretch is all the more painful for those of us who had to contend with significant adverse events in childhood. This article has sought to continue on the work presented here previously (Devine, 2022). I have tried to look at the process of identity formation as outlined by Margaret Mahler’s work in the separation individuation process and how this process could be impacted by parental alcoholism. In addition to this, I have sought to prompt the reader to reflect on how these dynamics may be impacting experience today. I have invited the reader to engage with the material as a practitioner personally impacted by these dynamics in childhood and as a practitioner whose clients have been influenced by these dynamics.

Mick Devine is a clinician working in addiction treatment for over 25 years with Tabor Group Addiction Treatment services in Cork. He is an accredited counsellor and supervisor with Addiction Counsellors of Ireland. He is particularly interested these days in the limitations imposed by the terrors of living with addiction in childhood and the development beyond them for himself and others. He is also interested in the spiritual dimensions of human development and is a student of the Ridhwan School. He encourages readers to get in touch at mick.devine@hotmail.com and to visit Silent Voices pages of Alcohol Action Ireland.

References

Almaas, A.H. (1988). The Pearl Beyond Price Integration of Personality into Being: An Object Relations Approach. Diamond Books.

Brown, S. (1988). Treating Adult Children of Alcoholics: A Developmental Perspective. John Wiley and Sons.

Dayton, T. (2012). The ACoA Trauma Syndrome: The Impact of Childhood Pain on Adult Relationships. Health Communications Inc.

Devine, M. (2022). Ongoing recovery for the Adult Child of Alcoholic (ACoA) therapist. Inside Out, 97, Summer 2022, 39-46.

El-Guebaly, N., West, M., Maticka-Tyndale, E., Pool, M. (1993). Attachment among adult children of alcoholics. Addiction, 88(10):1405-11. https://doi:10.1111/j.1360-0443.1993.tb02027.x

Kaplan, L.J. (1978). Oneness and Separateness: From Infant to Individual. Touchstone Book.

Mahler, M., Pine. F., Bergman, A. (2000) The psychological birth of the human infant: Symbiosis and individuation. Basic Books.

IAHIP 2022 - INSIDE OUT 98 - Autumn 2022