Open Letter to the Family of an Alcoholic

I hope I’m not off base here, but I had lunch with C____ on Thursday and remain seriously concerned.

It is my understanding that C____ has medical, physical, psychological, and nutritional problems that require expert help. He is a heart patient who almost died in March from congestive heart and organ failure; he claims to me that his heart problems do not include high cholesterol and that he does not need to monitor his cholesterol, HDL, LDL, or triglyceride intake; he is an alcoholic who currently insists to me that he has ceased drinking when he has admitted otherwise to family members; he currently acknowledges to me that he continues to smoke “occasionally”; he is obese but claims to me that, at 6’4” and 240 lbs, he is merely overweight and needs to get down to 220 lbs. (At 6’4” ideal weight is actually in the range of 175 to 190.)

When I was C____’s age, 35, I too had serious medical, physical, psychological, and nutritional problems that cost me my marriage, my health, and my job. I was an alcoholic; a 20-year, two-pack-a-day unfiltered cigarette smoker who exhibited precursory symptoms of pulmonary emphysema; and severely unfit, nutritionally bankrupt and couldn’t run to the end of the block. Fortunately I had an athletic background from middle school and three years in the military that allowed me to manage my own return to physical health through exercise (it was two months before I could run around the block) and I sought psychological and nutritional (Cooper Clinic) counseling on my own. Since then I have been directly involved with several other families with alcohol abuse and eating disorder problems and have even participated in a few interventions. I should add that my only sibling died due to substance abuse when he was 22.

Consequently I may be more sensitive to situations of this sort. But as early as late 2008 to early 2009 it was evident to me, who only talks with C____ once every couple of weeks and sees him once every month or two, that his behavior was regularly altered due to substance abuse of some sort; that he was obviously obese; and that he couldn’t walk up a flight of stairs without getting out of breath. By July 2009 I recognized that C____ had an alcohol problem and directly confronted him about it by phone and by email but was soundly ignored and kept at a distance thereafter.

From my own personal experience and from the experiences of those dear to me, it is my understanding that friends and families in situations such as this must recognize that they are an integral part of the problem and cannot solve it themselves. In fact friends and family members must often get completely out of the way as they sometimes only make matters worse. Expert professional help is required to recover.

I understand N____ is attending Al-Anon meetings – of course, it’s critical that family members V____, D____, and M____ attend as well if they aren’t already. Al-Anon will likely reinforce that the family isn’t going to solve the problem and that only professional treatment will.

It’s also my experience that alcoholics actively manipulate friends and family members and will do just about anything to maintain the status quo – they insist they have been put under “too much pressure,” that in spite of the pressure they are handling the situation themselves, that they don’t need advice, only “support,” that those confronting them directly or offering advice are “bad guys” or “pushing too hard,” etc. It’s difficult to ignore manipulations of this sort – just one of the reasons why treatment must be left to professionals..

I am seriously concerned that C____ may have relapsed since his initial three week program, that he may not be with us in a year or two if he doesn’t get back on the road to recovery immediately, and that reentry into a 30 to 90 program is probably called for. His current regimen allows him to play at recovery but he seems to still be in major denial, still sneaking smokes and drinks, and ultimately does not appear to be addressing his core problems.

I have not researched the subject in the last ten years, but back then (and even now as far as I know) there were no first class treatment facilities located in Texas.

Of course, one of the most famous facilities is the Betty Ford Center at Rancho Mirage – expensive but there are many good resources on their web site and I suspect that counselors there can recommend other facilities. http://www.bettyfordcenter.org/

For referrals, I can recommend Judith Sampson, Ph.D., Clinical Psychologist, Suite 203, 5952 Royal Lane Dallas, TX 75230, (214) 691-7434. Judith does not personally handle matters of this sort but is one of the top clinical psychologists in this part of the US, teaches at UT Southwestern Medical School, has supervised over 70 Ph.D. candidates there, is extremely active in the North Texas psychoanalytic/psychotherapy community; and knows who all of the resources are.

Also, I asked Stephen Scherffius, M.D., a well connected North Texas psychoanalyst, for a referral and he suggested Joe Gaspari, M.D., psychoanalyst and addiction psychiatrist, 214-369-6335.

Another couple of points –

First, it is my personal experience that, due to the litigious medical environment, cardiologists tend to over-medicate (read: cover their ass) with shotgun drug cocktails and even argue that it is prudent and cautious to ignore significant side effects. C____’s recovery may be severely affected by side-effects that adversely alter him physically and/or emotionally. It is my opinion that my own mother, a congestive heart failure patient, died as an indirect result of over-medication by her cardiologists, one of whom was one of C____’s cardiologists at Presbyterian. C____ needs a family advocate or medical ombudsperson who can monitor his current 20+ drug cocktail for evidence of over-medication and take on/confront prescribing physicians as necessary. In fact, confrontation may already be necessary – when I had lunch with C____ on Thursday, he was not his usual self; a bit numb, impatient, checked out; perhaps unable to focus; obviously altered.

Second, when C____ and N____ initially invited me to their Kuaui trip and marriage celebration I declined to attend because, at the time, it was clear C____ had a problem that wasn’t being addressed and that the problem was manifest before or soon after they met. I’m uncomfortable celebrating their union at this time, much less in Kuaui, one of the premier party capitals of the world. The event will subject C____, an active heart patient, to the physical and emotional stress of having to carry on for days as the center of attention and as though everything is just fine before 50 or so family members and friends.

Do C____ and N____ actually know what their relationship will look like on the other side of his recovery? Will C____ even manage to recover fully? I don’t know about others who care about these two fine people, but I would be much relieved to learn that the marriage and celebration had been postponed until C____ was well on the road to recovery.

That all being said, I now need to repeat that I may be totally off base here. C____’s family is much closer to the situation than I am, may already be aware of everything I have stated, may be completely on top of the situation, and C____ may be in the best possible place with regard to treatment and recovery.

I would be immensely comforted to learn if that is the case.

Absent that information though, I am compelled to communicate as best I can my thoughts on the situation. I hope you can appreciate how risky it is to address a message such as this to someone’s family. My only hope is that C____ will manage to recover as completely as possible with the caring help of his family and friends.

In the meantime – C____ seems to expect me to “support” his denial and impaired judgment (unacceptable to me) and I feel compelled to confront him (unacceptable to him). So I don’t expect to initiate further contact with C____ until and unless someone has something specific for me to do.

But if I can contribute physically, emotionally, or even financially, I hope I can be among the first called to help.