When most people hear the term of abuse, they generally tend to think of sexual abuse or some type of physical abuse or violence.
Whilst these types of abuse are certainly a large part of the effects and consequences of active alcoholism and active addiction, there is a wider context to the whole issue of abuse which may come up in rehab and in the extended process of recovery in Alcoholics Anonymous and other 12 step fellowships once the individual has left Rehab.
Anyone entering rehab will at some point begin the process of dealing with some of the underlying emotional drives that have fuelled their alcoholism. This may well include some type of physical or sexual abuse that they had experienced by those children or as adults.
Other people may understand the concepts of abuse but feel they do not apply to them in terms of their life experience. This understanding and experience of different types of abuse may change over time once in recovery, although not necessarily always.
The individual entering rehab needs also to be aware of the abuse they may have caused other people as a consequence of their alcoholism or addiction.
This may not necessarily have been of a sexual or physical nature, but may well have been of an emotional or mental character.
It is important to understand that the literal meaning of abuse is one individual taking advantage of another individual for their own benefit, or of using or manipulating that individual to gain some benefit for themselves at the cost of that individuals well-being.
Given that type of abuse, the reality of active alcoholism is that it is quite likely that the alcoholic has in some ways or other spent a lifetime trying to get their own way and hurt other people in the process.
It is unlikely that the time spent in rehab will do anything more than touch the surface of this, but it is important that the individual in rehab begins to understand the nature of their alcoholism in the context of how they may have hurt other people.
It is important also to mention, that there is wider potential for abuse in the recovery process once the individual has left rehab. This is a subject that rarely gets talked about but should be flagged up. It is not unique to the 12-step process, but is a possibility in any type of therapeutic relationship.
Any therapeutic relationship where there is a type of power imbalance gives rise to the potential of someone misusing or abusing that power if the other person is vulnerable.
What is important for the individual in rehab is to realise that their recovery process is one where they should be looking to own their own life, and that other people helping them both in rehab and once they have left should be looking to help that individual reclaim a sense of power over their own life, not try and entrap them in any type of enmeshed relationship.
It is often difficult and unwise to try and define abuse. It is important however for the individual to be aware that any type of therapeutic relationship has the potential to be abusive, even in fairly minor ways. This will give the individual a sense of power and control over their own life that will ultimately give them the opportunity to seek the real freedom that the recovery process can offer.