When an alcoholic enters a rehab/treatment center there is likely to be a substantial trail of chaos and damage behind them. This is inevitable given the nature of alcoholism, and it may take a considerable period of time before the reality of this chaos dawns on the people involved.
A large part of the chaos will be down to actions and behaviour that the alcoholic has exhibited during his/her drinking, and there will also be considerable damage done to all relationships that the alcoholic has in their lives. These relationships will include friends, family, work colleagues, acquaintances etc.
A rehab/treatment center will begin the process of beginning to pick up the pieces of this chaos by creating an environment where the most important thing is that it is not happening any more. To the alcoholic it may seem like a whirlwind has stopped and they feel quite lost not knowing what to do.
The term abuse can mean many things to many people, and has a wide range of spectrum from manipulating people to get what you want, to violent and extreme sexual and predatory abuse. In the context of a rehab/treatment center, the nature of abuse that the alcoholic has perpetrated on other people will become clear over time.
It is always difficult to generalise about the nature of abuse, but it is fair to say that once in a rehab/treatment center the alcoholic will begin to realise that the nature of their life was in some sense to try and keep everything in control. This need to control other people’s lives, at different levels, will inevitably lead to them using people to get what they want.
A rehab/treatment center will hopefully look at the bigger family picture of the alcoholic, their partner and any siblings as well as extended family. If there has been any real abuse/violence this is where it is most likely to have been perpetrated. The potential severity of any abuse or violence should not be underestimated.
It is also true that once in a rehab and sober, the alcoholic may begin to realise the enormity of the trail of destruction that they have left behind them.
If this includes a legacy of abuse and violence the shame of it may be overwhelming. It is in part the safety of a rehab/treatment center that they should both be able to own the reality of what has happened beforehand, and be willing to stop and move forward and take responsibility for what has already happened.
If there has been a significant amount of abuse or violence within the family, it is possible that there may be actual or potential legal proceedings to be considered. A rehab should have a confidential/ethical policy of how they approach these issues, giving weight to their legal obligations to the family, and their moral obligations as well. Their confidentiality policy should be spelt out on their website so that the family can see it, as well as the alcoholic prior to admission.
If the family has been heavily affected by abuse or violence, they may either be in denial of it, or have already taken precautionary measures against it continuing. The reality of this will impact on the way a rehab is able to incorporate the family into any type of family therapy or family reconciliation process they may wish to happen.