Sybil Wolin, Ph.D.
Steven Wolin, M.D.

Children of Alcoholics: Selected readings

As a clinician, you are undoubtedly familiar with the clinical portrait of the overly responsible child of an alcoholic (4, 8, 22). The syndrome has been widely described; you have probably seen more than a few clients who fit the diagnosis. Variously called hypermature, co-dependent, responsible ones, or enablers, overly responsible children take charge when alcoholic parents abdicate their roles. These children respond to their parents' drinking by growing up fast. They react to the early signs of a parent's drunken rampage by putting pajamas on the younger kids and taking them to a neighbor's house to sleep. They do the weekly marketing and cook meals. They take care of the family's laundry. They clean the house and throw away their parents' broken liquor bottles. And they go out late at night to bring dad or mom home from the bar.

As a result of these children's efforts, some structure and consistency are achieved at home. However, according to conventional wisdom, the price they pay Is great, amounting to no less than giving up significant parts of their youths. Often, as they grow into adulthood, overly responsible children become anxious, depressed, tense, and distant from others. They may enter into unhealthy relationships and overwork themselves to the point of exhaustion. Or attempting desperately to compensate for the lost pleasures of childhood, they may become excessively demanding and dependent. In all, overly responsible children bear the scars of their past.

We suggest that the pessimistic picture of overly responsible COAs, drawn above, is a partial truth which reflects a clinical bias toward identifying pathology In COAs. Having worked under the Influence of a pathology bias, we know well that there are good reasons for it. Talking about pathology feels safe to clinicians; talking about strengths feels dangerous.

First, talking about deficits and symptoms gives us a professional legitimacy that talking about strengths does not. Second, our vocabulary of strengths is scant and pallid In contrast to the technical, high sounding lexicon available to us for discussing pathology. Third, the topic of strengths is difficult emotionally. Turning our attention away from forces that are harmful and dangerous to children violates our natural sympathies toward the young. To add to the matter, talking about their strengths instead can feel like excusing the inexcusable. Fourth, the topic feels politically risky. We are rightfully wary that professional acknowledgement of strengths in children of hardship could easily become justification for trimming the budget by withdrawing support services.

For all of these reasons, a bias toward pathology is understandable. Nonetheless, it Is also limiting and warrants our scrutiny. Emphasizing, as it does, problems and symptoms, a pathology bias diverts the clinician's interest away from clients' strengths. It can lull us into using such negatively tinged descriptors as "overly responsible," "co-dependent," and "enabler," and ultimately it leaves us with little to build on in therapy. Therefore, in this chapter, we invite you to examine the pathology bias by focusing on the usefulness of "over-responsibility" as a diagnosis and as a therapeutic term to be used with clients.

The motivation of COAs who step into the roles abdicated by their parents has been typically attributed to the chaotic atmosphere that prevails in homes overrun by alcohol (1). This connection between the COAs' behavior and their disrupted home lives makes good sense and rests on well accepted precepts emerging from the field of child development.

We know that children need and want stability and structure. Families disrupted by the influence of alcohol, all too often, provide neither. Lacking basics such as food, clothing, safety and medical care, COAs learn that the adults around them cannot be counted on to provide. Consequently, many COAs act defensively to establish, by themselves, the structure that they and the rest of the family require.

Given the range of choices that are easier and perhaps more likely and natural for adolescents, we are struck by the widespread acceptance of a diagnostic formulation which reduces taking over for an absent parent to a defense. Alternately, we suggest that such a choice can more accurately be seen as a moral achievement which, like any other achievement, comes at a price.

It does not seem farfetched to us that a strong sense of compassion, fairness, and decency, each of which we include In our concept of morality, account for bringing mom or dad home from the bar rather than letting either one be put out on the street at closing time. Nor does It seem hard to imagine that moral sentiments could prompt COAs into taking care of the younger kids in their families despite the personal costs. What does seem strange to us is that the moral sensibilities and the strength of character of many COAs can escape clinical attention, be misconstrued or even disparaged as pathology, or be spoken about primarily in terms of psychological costs.

A relevant perspective can be found In the work of Robert Coles, the noted child psychologist (4). Coles has traveled around the world to interview children living in dire conditions. He wanted to know what course child development takes in environments commonly thought to bring out the worst in people.

Coles' work has taken him and his wife Jane to the American ghettos and migrant camps, the Brazilian favelas, and the South African mandated homelands. Where corruption and brutality are rampant, Coles found children who could judge right from wrong and who were honest, charitable, and fair. Coles marveled because there was little in the environment of these children which could account for their development.

Though Coles had been psychoanalytically trained, he did not even hint at a defensive component to the morality he observed among downtrodden children. Instead, he sees their morality as a positive, sustaining force that gives purpose and direction to their lives. Morality, according to Coles, is not an antidote to pain, nor does it prevent pain. Rather, morality is an accomplishment that makes life possible despite pain. We suggest that concept of morality, as described by Coles, has untapped value for organizing our clinical thinking and work with COAs. Consider the case of Terry and the injustice we would do her by diminishing the role of moral values In the choices she made.

Terry is a young woman In her twenties whom we interviewed for our video series "Survivor's Pride: Building Resilience In Youth at Risk" (11). By her own description, Terry played the role of mother in her family, meeting all the household and child care obligations that her alcoholic parents neglected.

Terry's earliest memory of her parents' drinking and her own abandonment dates back to kindergarten. The eldest of four children, she assumed more and more of the care of her young brothers and sisters throughout her elementary school years. By high school, she was totally in charge of the household, and while she was determined to go away to college, and did go, separation from her family was a wrench. In her freshman year, when Terry's parents divorced, her mother left the home. The three younger children remained in the care of their father. Worried about their physical safety as well as their emotional well being, Terry interrupted her college career for two-and-a-half years to come home and hold the family together.

Terry told us that by choosing to return home, she was following the dictates of her conscience. She said further, that to this day, she felt good about what she had done. Nonetheless, she suffered. Being at home when she wanted to be in college was painful, and she began to drink.

At the time we interviewed Terry, she had not been drinking for over three years. She had some expectable symptoms related to her childhood, namely perfectionism, a recurrent feeling that she "could always do more," and some difficulty "playing." There was also a good deal that was positive in Terry's life. She was engaged to be married, had thought carefully and constructively about the nature of her relationship with her fiance, and could share her feelings with him freely. As she described it, they were "good friends."

Terry was also gratified to be completing an undergraduate degree in elementary education. She saw her career choice as a carryover from her past success with young children, both as a baby sitter and as an older sister. She said, "I love working with kids. A lot of my jobs were with kids... and I took care of my younger brother and sisters ... They thought I was their mother ... I babysat all over the neighborhood. Not just on my block because parents would refer me to other parents, and I'd get calls all the time. I was booked months in advance. And those families still remember me and ask about me."

In addition to extending her early loving experiences with children, teaching offered Terry an arena for exercising her moral commitment. She saw in education the opportunity to have the same positive influence that her own teachers had on her. She said, "I've always wanted to be a teacher, and even more so now, realizing that I can make a difference, not only in academic education. I had some really kind supporting teachers I remember, and they definitely helped me."

Shortly before we interviewed Terry, she had seen her mother. She related the incident to us. Having recently achieved sobriety, Terry's mother wanted to repair relationships with her children. She contacted Terry with the intended goal of making amends. Accordingly, she acknowledged all the "terrible things" Terry was forced to do as a child. She then apologized and asked for Terry's forgiveness.

For Terry's mother, the apology had the likely effect of relieving guilt. For Terry, however, it hurt more than it helped, running afoul of her view of her self as a caring, decent, and competent person. Moreover, the apology robbed Terry of the pride she felt in her behavior as a child, and it undercut her efforts to rest her current decisions on her past accomplishments.

Terry explained, "Pride ... hum ... I get a lot of the opposite from my mom. She's always apologizing now that she's in recovery. And she feels that she made me responsible for so many things, and it's hard to be proud when she's saying that this was such a horrible thing. So it's kind of a dilemma for me cause I am proud. I did the right thing and I feel like I did a good job sometimes, the best I could, more than would be expected of a child. Then to have her tell me that she is so sorry and it was horrible and that's not the way It should have been. She's right, but ... how about a pat on the back"

For clinicians to view Terry with a pathology bias, to dwell primarily on the psychological costs of her choices, to label her as overly responsible is to make the same error in judgment that her mother made. We call the mindset that spawns such pessimistic pathology-oriented thinking the Damage Model (10).

In the Damage Model troubled families, such as those with alcoholism, are seen as toxic agents, and offspring are regarded as victims of their parents' harmful actions.

COAs, according to the Damage Model, are vulnerable, and locked into the family. The best they can do is cope or contain the family's harmful influence at considerable cost to themselves. Inevitably, the accumulating price of coping takes its toll and results In symptoms and behaviors that make up the general category of pathologies. In adolescence and adulthood, pathologies are layered on pathologies, and eventually the child is no better off than his or her troubled parent.

The role of the therapist in this scenario is to uncover and give voice to the hurt feelings and anger in COAs such as Terry. Therapy alms to promote healing through the processes of grieving and of expressing hurt and anger. Biased toward disease and fixing what's wrong with the client, the Damage Model accommodates neither Terry's positive valuation of her own actions nor her resources to help herself. A different approach is required to understand Terry and others like her more fully.

The Challenge Model builds on the Damage Model (10). We intend it as an amplification or complement to the Damage Model and not as a refutation or replacement.

The Challenge Model starts, like the Damage Model, with the observation that troubled families can inflict considerable harm on their children. In the Challenge Model, however, two forces, represented by interlocking arrows, are at work as the child and the family interact. The troubled family is seen as a danger to the child, as it is in the Damage Model, and also as an opportunity. Children are vulnerable to their parents' harm, but they are also challenged to rebound by becoming active agents in their own lives. As a result of the interplay between damage and challenge, the children in troubled families are left with pathologies that do not disappear completely and resiliencies that limit the influence of their damage and promote their growth and well-being. The shaded and unshaded areas on the Challenge Model diagram represent the contrasting elements of strength and weakness in the inner life and outward behavior of COAs like Terry.

In the process of developing the Challenge Model, we interviewed adult children of troubled families, including children from alcoholic families. Our aim was to uncover both the strengths and the damage that resulted from their early, difficult experiences. Our analysis of the interview transcripts certainly revealed elements of pathology. But, unconstrained by a primary interest in sickness, we could also see common positive themes or clusters of strengths. We have called these clusters of strength resiliencies and have named them as follows: insight, independence, relationships, initiative, creativity, humor and morality. For the purposes of this paper, we will focus exclusively on morality.

We define morality as the activity of an informed conscience (10). It is the wish for a good personal life grown large and inclusive. In adults, morality is defined as "serving" or devoting time and energy to improving institutions, community and the world. For example, choosing a career in teaching, as Terry did, because of the opportunity it offers for helping children; including charitable contributions in one's household budget; volunteering to tutor the illiterate; donating blood to a blood bank; supporting political reform; looking out for friends who are alone at holiday time; giving up a favorite activity to help a sick friend; reducing a standard fee for a needy client; writing a letter to the editor about biased reporting; or helping a mother search for a lost child on the beach. Morality is the capacity to move beyond self interest and act on the basis of a larger common good.

As the generous spirit of the people we interviewed revealed itself In these and other examples, we were deeply touched. We also wondered how those, given so little as children, had honed their moral sensibilities. Their explanations, which were similar, did not reflect an inclination to see themselves "as over-responsible" but rather as spiritual, mindful, generous, and moral people. For example, Noreen, an adult child of an alcoholic, said, "coming from the kind of home life I had... I'm left with a deep awareness of just how fragile the good things in life are and how easily they could disappear or just not be ... I have an abiding of appreciation for what I have - a sense of indebtedness and an obligation to repay."

Almost uniformly, the kind of sentiment expressed here could be traced back through early childhood and adolescence. Noreen, for example, said, "I knew my father was a mean machine. I didn't think that I or anyone else in the family deserved his violence. My father's brutality was his problem. In fact, that was one of the worst parts about growing up in my family. There was no rhyme or reason to him. What he did was so unconnected to what we did."

Noreen's words strongly suggest that, from a young age, she was capable of accurately judging the injustice of her parent's behavior. We suggest that, as children, many COAs had the same good judgment as Noreen. Indeed, applying a right - wrong standard to their parents was the first step In the achievement of their morality.

In keeping with a Damage Model, COAs are not normally credited with the early achievement of morality. Instead, the view has prevailed that young children are emotionally incapable of judging the rights and wrongs of their parents' behavior (2, 6, 7). Wanting and needing good parents in order to be safe in an overwhelming world, they are blinded to their parents' faults. Even when parents are abusive and neglectful, children will not hold them to account. Instead, they will blame themselves and construe the abuse and neglect as treatment they deserve. In short, on the basis of a pathology bias, abuse specialists (8) have become convinced that children will make themselves "bad" in order to preserve an image of their parents as "good."

More In keeping with the Challenge Model, our interviews revealed a shifting moral awareness among COAs, as children, rather than a stable sense of themselves as bad and their parents as good. At their neediest times, they succumbed and were, in fact, willing to accept the blame for their own abuse and neglect. At other times, however, they were able to be strong, to brave the world alone, and to see matters more clearly. They knew that abuse was bad and that they deserved better.

The research of Dr. Robert L. Selman confirms our impression (9). In a study looking at social development, Selman showed that young children are capable of acknowledging that parents are fallible. Asked hypothetical questions, seven-year-olds differentiated between the justifiable actions and the mistakes of their parents. In their opinion, punishment is not necessarily deserved because a parent metes It out. Rather, punishment can be warranted or unwarranted, fair or unfair. The seven-year-olds who spoke to Selman were capable, as the Challenge Model suggests, of skepticism toward parents, saying that it is wrong to punish children without considering the reasons for their behaviors.

In adolescence, the capacity for judging, found in our interviews and confirmed by Selman's research, develops into a coherent system of values, including decency, honesty, fairness, and justice. We suggest that this value system drives the behavioral pattern we have tagged as "over-responsibility." As Noreen told us, "It was a matter of tolerance. I saw all the suffering and I couldn't abide it. The worst was that my father would go after the younger kids, the little ones who couldn't defend themselves. I felt that I had to protect the little ones. It was a moral obligation, something I couldn't avoid, something any decent person would do."

In this paper, we have shown that the behavior of COAs who meet the obligations neglected by alcoholic parents has been seen commonly as a defense. As such, this behavior pattern is believed to serve an adaptive purpose for COAs when they are young but, ultimately, it becomes the foundation for pathology in adulthood. Alternatively, we have proposed that the COAs' evolving moral sensibilities underlie the willingness and capacity to step in for neglectful and/or abusive alcoholic parents. Therefore, their behavior, which has been commonly tagged as "overly responsible," would be more properly regarded as an achievement with a price rather than as a defense.