Recently, I have received numerous emails and comments from the loved ones of high-functioning alcoholics (HFAs) who are unsure how to deal with the HFA in their life. Loved ones of HFAs are often confused about how to approach these individuals because there is often a lack of tangible losses to point to, only emotional consequences.
HFAs typically do not realize the extent to which their drinking affects others. The fact that they are "functioning" and able to go to work, excel in academics, provide for their family and still drink excessively feeds their denial. They believe that their drinking only impacts themselves, that they deserve to drink because of their hard work or stress, and that if life appears "put together" on the outside that they are entitled to keep drinking. This distorted thinking is part of the denial that HFAs experience and that enables them to continue drinking, despite the harm to others, risks, and negative consequences that they may experience (hangovers, drinking and driving, health risks).
Being an HFA affects every aspect of that individual's life—but they are often unable to see this truth until they get sober. In terms of family life and friends, there is also the problem of "secondary" denial that loved ones may have about an HFA by not believing that they are "real" alcoholics. This powerful sense of denial also prevents the loved ones of HFAs from intervening. HFAs may provide the main source of income for a family and therefore the spouse or partner may not feel that they have the leverage to persuade the HFA to get help.
In terms of intimate relationships, many spouses or romantic partners have reported that they experience difficulty connecting emotionally with the HFA. Alcohol is the HFA's best friend and it is hard for anyone to compete with that relationship. In addition, these loved ones will report that while the HFA may provide for the family financially, that they are not able to be supportive emotionally. Alcoholism corrodes relationships. This can happen in a subtle manner over time, but can ultimately damage and destroy families.
So what should the loved one of an HFA do?
Any conversation with an HFA about his or her drinking should occur when the alcoholic is NOT under the influence of alcohol and can often be most effective when the HFA is hungover and possibly feeling guilt or remorse. It is important to express to an HFA how his or her drinking is negatively affecting you (emotionally, spiritually, physically) and how you perceive it is harming others as well (friends, children). In order to prevent an HFA from getting overly defensive, you can place the emphasis on your feelings and concerns—instead of stating how you think he or she should be living or acting.
You can also dispel some of the myths and stereotypes about alcoholics that I have written about in other blog posts on this site and in my book Understanding the High-Functioning Alcoholic. You can help to slowly chip away at his or her denial, but it is also important to come from a place of compassion and not from a position of judgment.
Just because you open up about this issue does not mean the HFA in your life will immediately get help. However, what you are doing is planting a seed that may increase the chances that this individual will get help in the future. If the HFA is open to your concerns and is willing to seek help, he or she should also receive an assessment by a therapist or physician about what level of care may be appropriate. You can also suggest finding a recovery program support group such as A.A., SMART Recovery, or Women for Sobriety, which have meetings online and in person throughout the country and internationally. You can even offer to attend an "open" meeting of one of these support groups with your loved one to ease their fears.
Sometimes an HFA many become defensive and express that they are unwilling to seek help for their drinking. He or she may not believe that they are alcoholic and believe that they require more concrete evidence of being alcoholic in order to even consider getting sober. You may also suggest that they visit the "Rethinking Drinking" online assessment by the NIAAA and if necessary, try to set low-risk drinking limits for themselves through this online program. If the HFA is not able to adhere to low-risk drinking limits (i.e., no more than three drinks in a sitting, no more than two times a week), his or her lack of control over drinking may become clear and he or she may become more open to seeking help.
There may come a point where the HFA in your life is unwilling to seek help and is continuing to drink alcoholically despite your efforts to offer help. Therefore, you may need to set clear limits and, for example, state that you will not spend time with them when they are drinking or take a break from your relationship with them (romantic or friendship) until they get help. If you make it clear that your loved one's drinking is leading you to put distance in your relationship, it may have an impact as well as protect you from the emotional toll of having an active alcoholic in your life.
Loved ones and friends of HFAs can also seek support for themselves in order to learn how best to navigate their relationship with the alcoholic in their life, to detach emotionally and to heal. Al-Anon is a free, anonymous national support for the friends and loved ones of alcoholics and ACOA is a free, anonymous national support specifically for adult children of alcoholic parents. The book Co-Dependent No More by Melody Beattie is a resource for the loved ones of alcoholics that is highly recommended by many therapists. In addition, attending individual therapy or even family therapy with the HFA can be effective. It is best to find a therapist who specializes in treating addictions, and you can often do this search through your insurance company or by asking your physician. Finally, as a last resort, there are professional "interventionists" who are available to assist family and friends of an alcoholic in confronting that individual, presenting ultimatums, and providing resources with the hope that the person will ultimately agree to seek help.