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Updated February 20, 2002
Attempts to Survive in an Alcoholic Home

Ask Dr. Bill

Dear Readers,
Last week, I acknowledged "Children of Alcoholics Week, 2002" sponsored by the National Association of Children of Alcoholics by printing a copy of CAST, a screening test to determine the level of trauma experienced by kids struggling with problems resulting from living in a home with an alcoholic or other drug addicted parent. But, CAST is simply a measurement...usually given only AFTER somebody recognizes a child with a problem!

What about these kids? Who pays attention to their pain? They carefully guard what is usually a well-kept family secret...a home with an addicted parent. One of every five youngsters who enter a pediatrician's office, anywhere in the USA, lives with at least one such parent. But, it has been estimated that only 5 percent of the 12 to 15 million school-age children of alcoholics in the U.S. are identified and treated! In spite of efforts of local treatment centers like our own nonprofit Institute, and of educational programs like that offered by , most of these kids are still invisible to the professional. Those who do attract attention are usually "acting out" their problems in contrast to those many children who are "adjusting."....... Out of sight, out of mind!!

Children who live with an alcoholic parent, usually assume one of 4 survival roles which can be diagnosed if looked for by an alert pediatrician, a caring adult surrogate parent, or teacher: The first of these, usually the eldest child, is known in the treatment field as THE FAMILY HERO... an overachiever..always doing what is right, is often called the "little mother" or" little man" of the family, seeking everyone's approval. The "white shoe" syndrome; the A student; the 4-letter man. Nobody knows that inside this kid there is anger, confusion, and inadequacy because he is unable to solve parental problems. This child represents the family's need to have someone to be proud of. Adulthood will likely produce a compulsive workaholic.

The SCAPEGOAT, often the second child and jealous of the eldest's successes, turns to hostility and defiance, serving the family by diverting the focus of the problem away from the addicted parent..."see what he/she is doing? etc.,etc" This child is usually withdrawn and sullen. Inside feeling hurt, abandoned, rejected, guilty and having no self-esteem. This is a child who will takes chances. Most likely, do drugs... get drunk... become addicted. It means trouble..unplanned pregnancies, jail, etc.....you name it. But, paradoxically, because acting out draws attention to a need for treatment, this child may be the family's only survivor. The LOST CHILD hides inner sadness and anger, withdraws, tries to become invisible and often suffers from severe depression. This child provides family relief: "at least one kid we don't have to worry about." This is the loner, the day-dreamer who appears withdrawn, shy..The one who sits in the back of the class; is no trouble, while quietly getting Cs on report cards. A common escape for this child is suicide.

The family MASCOT is the immature kid who vies for attention, has a short attention span and is usually hyperactive. Crying on the inside, laughing on the outside; filled with fear and loneliness; this compulsive clown is desperately trying to divert attention away from the abusing parent at home.

Who "oversees" these lonely children?... This person, known by addiction therapists as the family's CHIEF ENABLER, is usually the spouse...the leading "family-secret" keeper...the one whom the alcoholic depends upon the most; who usually feels virtuous for putting up with the alcoholic and is frequently the object of the addict's anger. On the surface appearing rigid and unloving but , beneath that seemingly cold facade, there is usually a frightened, angry, and very lonely human being whose attempts to control the uncontrollable often results in themselves, instead of the addicted parent, becoming the major recipient of the children's hostility as they grow into adulthood.

This is a family that's hurting and nobody sees their pain!..Unless YOU do!! If so, call me.


Dr. Willian Van Ost, M.D., is a Co-founder of The Van Ost Institute for Family Living, a non-profit outpatient center for treatment of addictive illnesses. Located in Englewood, it offers continuing, free weekly educational lectures. (Call 201-569-6667, e-mail to vanost@msn.com or visit www.vanostinstitute.org). Dr. Bill welcomes questions about addiction and effects on the family.

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Address inquiries:
Dr. Bill
Care of The Van Ost Institute
150 East Palisade Ave.
Englewood, NJ 07631-3010
Phone inquiries: (201) 569-6667
E-mail to: drbill@vanostinstitute.org

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