The Men's Center, Inc.

     Let's call them the family next door. Wherever you live, from ghetto to suburb, they live, too. They have jobs a lot like yours. Their kids are in school with your kids. When you barbecue in the backyard, smoke from their pit tells you they're grilling, too.

     Much as your families may look alike, there's a difference. The family next door is the typical alcoholic family. What's normal in the neighborhood is the image they'll create. They work at it overtime to cover for at least one member whose drinking is out of control.

     They are living a lie, a denial of reality, a denial of the many emotional, physical and even spiritual problems they endure. Chances are, you'll eventually notice. You'll hear their kid is in trouble at school or that one spouse seems tired and nervous. Only in the late stages will you see direct evidence of the drinking problem.

     You won't say anything, and neither will they. You'll probably act as though you didn't notice. So will they. That's denial too.

     Your next-door neighbors aren't exactly alone. There are an estimated 10 million alcoholics in this country and 18 million heavy drinkers. They are affecting the lives of about 28 million children, more than 6 million of whom are under 18.

     One in three Americans - 56 million - say alcohol abuse has troubled their families. Yet if asked to describe an alcoholic, most people wouldn't name their fathers, mothers, sisters, brothers or children. The word dredges up an image of derelicts who sleep in missions downtown, a group comprising no more than 5 percent of all alcoholics.

     Again, denial.

     In all its many forms, experts say denial is the major stumbling block in recognizing, treating and preventing alcoholism. Alcoholics want to believe they can still control their drinking. Spouses want to believe the marriage is working, or they are afraid to make needed changes. Society wants to maintain its image that alcoholic drinking affects the unfortunate few.

     That image is cracking as public figures such as Betty Ford and other celebrities speak openly about their addiction. They are followed by an increasing number of recovering alcoholics also willing to be honest. A very vocal movement of adult children of alcoholics is increasing awareness of the pain of growing up in an alcoholic home.

     It is finally sinking in that alcoholics do not choose to be alcoholics, that their drinking is out of control and out of the control of those who love and care for them. As the shame about the disease lessens, the fog of denial is lifting.

     It becomes easier to imagine an alcoholic in a family like yours when you understand how normal it can look. If a tenth of the adult population in this country is alcoholic, it's likely someone you love, care for, or work with is directly affected.

     It's also easier to see that drinking problems often get others labels. A couple fighting about sex and money in a marriage counselor's office may never mention that one of them is numb with drink five nights out of seven. Kids worrying about these fights don't pay attention in class and become "problem students." Adults seeking help for unaccountable depression never mention that alcoholism was part of their childhood trauma.

     These are all ways to avoid looking at the primary problem. Keeping the secret prevents people from acknowledging and dealing with their losses, and many family therapists believe denial creates more problems than alcoholism itself. The family next door pays a heavy emotional price for maintaining its image.

     The alcoholic home is one of constant stress and loss. The progressive sickness creates slack the family must pick up. The caretaker spouse assumes ever-increasing responsibilities, and each of the children gets locked into a specialized role that hampers development: One may be in charge of doing great in school to bring credit to the family. Another provides comic relief. A third gets quietly lost in the shuffle, and one will get blamed for every thing that goes wrong.

     The nature of the roles depends to some degree on individual family circumstances, but the overall family pattern is depressingly predictable. With-out treatment, the family remains frozen in its altered roles even when they leave the alcoholic home or when the alcoholic becomes sober.

Co-dependency

     The families behavior becomes so severly distorted that the treatment community recognizes it as co-dependency, an illness in its own right. Co-dependency describes a complex of problems related to compulsive care-taking of others that stems from low self-esteem.

     Because untreated family members can undermine the recovery of the alcoholic, most alcoholic treatment programs include some kind of family component. Typically, this will be a week of education and treatment designed to help maintain the alcoholic's sobriety when he or she returns home.

     Whether the spouse's co-dependence is a reaction to the alcoholism or, as others believe, a previously existing compulsion, insurance providers rarely pay for the family treatment. The cost is either absorbed by the family or the treatment center itself.

     Dr. Eugene Degner, the medical director or Parkside Lodge in Katy, says most modern treatment facilities are acknowledging the importance of co-dependence, regardless of its origin. Families, he says, deserve treatment too.

      "I am impressed with the pain of living with a practicing alcoholic, and I am incredibly impressed in what I see in the family program. Kids come in as terrified little people and walk out so changed. They respond much more rapidly than the patients," he said. Degner says the mistrust, anger and frustration of living with the practicing alcoholic and the resulting emotional disturbance in family members disappear if the alcoholic family practices a recovery program.

Generation to generation

     Family treatment began ...........