The term abuse is often referred to as an abuse of power as a way of explaining the nature of some of the harm done to people as a consequence of the abuse.
Whilst this may be true, at a practical level it is the effects of abuse that in many ways is most important in connection to understanding and treating someone’s alcoholism.
Whilst it is impossible to know completely, because there are no statistics, it is highly likely that most alcoholics have grown up in homes where one or both of the parents were alcoholics themselves.
If not directly then there is likely to have been generational alcoholism. When entering a rehab an alcoholic will begin to become aware of two issues in particular. One will be their drinking and the nature of the drinking, and the second will be an understanding of living with their emotional state and the fears and trauma that accompany it.
A rehab/treatment center, either through various types of therapy or some type of step work will begin the process of helping the alcoholic to understand some of the emotional drives that have fuelled their drinking and their alcoholism/alcohol abuse.
What may or may not become clear in a rehab, given the short length of time that people stay there, is that most of the destructive drives are rooted in childhood, and quite possibly there is a reaction to abuse having taken place.
Many people are horrified at the suggestion that abuse has happened in someone’s home.
People who work in a rehab and who will have responsibility for approaching this type of work need to do it very sensitively.
Many alcoholics are very protective of their parents, whether they were abusive or not, at any level. There are many reasons for this, and it is unlikely that time spent in a rehab will be sufficient to begin to unpick this process.
The nature of therapeutic work with an individual can happen at several different levels. A rehab/treatment center will have a number of trained counsellors and therapists available who will work with clients.
A rehab/treatment center is also likely to have a program of recovery adapted from the first five steps of the programme of Alcoholics Anonymous.
The objective of this therapeutic programme will be to get the alcoholic spend time that they have, whilst in a rehab, beginning the process of looking at themselves, and at some level owning and becoming accountable for the emotional drives.
Upon entry to a rehab/treatment center it is fair to assume that any alcoholic is going to be fairly angry.
There are many reasons for this but it is a safe working assumption. Effectively being told by someone in a rehab that they are the problem is if anything going to make them more angry.
How this issue is approached will depend upon the experience that the people who work in a rehab have, and how easily they can begin to gain the confidence of someone who is an alcoholic and help them see what the reality of their life has been.
Whilst it is always difficult to generalise about alcoholics, it is probably fair to say that most alcoholics will see alcohol as being the solution to their problems not the problem itself. This is in direct contrast to how most people who are not alcoholics will view their drinking.
The alcoholic will see the problem as how do they live with themselves sober. The period of time spent in a rehab/treatment center should be a time when the person feels safe enough to realise that they have emotional drives and distortions that have effectively fuelled the drinking.
Whether the time spent in a rehab is sufficient for them to realise that most of these drives originated in childhood, possibly, probably as a result of some type of abuse is a different issue. Bear in mind that abuse can range from mild neglect or deprecation of self-esteem, through to extremes of violence and sexual abuse.
Part of the job of a rehab can be to make people understand this distinction, and realise that the reality of accepting themselves determines how they live their life, and that self-awareness is a route to freedom.