‘Functional Alcoholics’…an oxymoron fuelling denial

If you are alcoholic you cannot function as a whole person. That is one definition of the condition. There is a behaviour in place (alcohol) that compensates for an emotional need (eg stress, self esteem, intimacy) that has become a need in its own right (continued drinking) so that this emotional need does not leak into the real world. Thus the person is not really known by those ‘close’ to them, as they perpetuate an image, a version of themselves, that is not quite the truth, all the while bolstered by alcohol. So do they function? Or do they only function?

Last weeks press commented on a middle class population drinking themselves into ill health and I believe these are the very same ‘functional alcoholics’. The commuters, workers, mums in the school yard – these are today’s problem drinkers it seems ‘responsible for 10 times the costs of young drinkers’ according to Alcohol Concern, ‘unwitting[ly] …taking serious risks with their health’ and drinking their stresses and exhaustion away. Only it doesn’t go away, it sits there ignited into its own need for more alcohol. To drink alcohol to compensate for emotional need is to make a monster.

And this functional behaviour, is this to appear civilized, all the while arguing and stressing behind the scenes?

I meet children of functional alcoholics who are often scapegoated into addictive behaviour themselves. Mutinous they sit in my rooms, often with a parent wringing their hands, bemoaning their loss of potential. And when these children start talking they are angry. They have often been given money to fix emotional need, as it is the currency that enables the parent to feel functional. They have been placed second to the drinking. The lies and secrets that they have been silently asked to keep so that the alcoholic status quo can rule has left them no alternative but to act out, or act in. Welcome to ACOA – the adult child of an alcoholic: self sufficient yet insecure, these children also often feel guilty about their feelings of anger and sense of neglect as they can see their parent is working ‘so hard’ or is ‘so damaged’ or that the child is ‘given everything’ so wherefore this sense of loss, of anger?

But sadly it does not surprise me. The denial in our society is supreme. Drinking is endorsed, celebrated as a badge of strength – caner’s pride – or brushed under the carpet (again) with bullish denial that shames the concerned into silence: ‘it wasn’t that bad’, ‘everybody does it’, ‘lighten up’, or  ‘do you want me to stop drinking and stay at home every night?’ Or some such variation on a theme that employs tactics that minimize, exaggerate, universalise, generalise – whatever they do they ameliorate the fact and park the issue one more time.

It is so very very hard for a family member to bring a concern about a loved one’s drinking – so hard that most people miss the opportunity for early intervention, coming to someone like me when they are on their knees – can you save my marriage / my job / have I ruined my children? But I need to say that the shame, fear and regret does not have to be such a burden if you get help sooner!

Ecstasy Trial

I am an advocate for medicine that works, and am personally enormously grateful that my Rheumatoid Arthritis is now in remission due to the well-researched medication I have been prescribed. But I doubt that RA meds trials would attract the kind of sensation seeking headlines that The Ecstasy Trials achieved last week. In a society where we bemoan the attraction of illegal drugs to our eg teen population, Channel 4 uses this very sensationalist profile to up its ratings and contribute to both Channel 4’s identity and brand as being ground breaking, and Ecstasy’s as being worthy of the limelight.

Of course scientists want to achieve notoriety and fame, and TV is the perfect vehicle; Channel 4 wants to be seen as ground breaking and edgy, and scientists are the perfect companion to lend gravitas; and I’m sure all those involved will argue for these trials’ validity – possibly even ridiculing those who argue against. A bit like the ‘do you don’t you [take drugs]’ exchanges that happen everyday in school playgrounds around the country: its humiliating to say ‘no, I don’t’. The power of the drug culture and the desire to be in the ‘in crowd’ was replicated I think by the slight ridiculing that happened on the programme when scientists debated the issue and David Nutt seemed to adopt a supercilious sneer.

The fact remains, television is a construction: to be accurate these trials need to take place in controlled environments to limit the influence of other elements.  Performing (and I choose that word deliberately) these trials on national television is not an appropriately controlled environment that would show with any certainty the effect of the drug only. Those taking part (including the scientists) are aware they are in front of millions of viewers, and researchers cannot be certain this has no effect. For example the argument for using a celebrity who would be comfortable in front of the camera was cancelled out as he sought to control his vulnerability on camera when the drug affected him. It was farcical and sadly, I believe, dangerous, as it brought Ecstasy into the limelight as something to experiment with, a play thing, despite the words of warning (to fulfill the requirement of a corporate disclaimer) by Channel 4 presenters advising ‘Do not try this at home’. Do you as I say, not as I do…

What is clear is that no one seems to know much about MDMA and its impact on the human brain. I’m no better informed after watching this programme either. Perhaps more serious trials could be undertaken, privately, responsibly and without sensation: submit the research through the normal channels and allow the process to take the time it needs for culture to adjust and Government to respond. This ‘quick fix’ approach that is so often represented by TV is not always positive, as ideas need time to germinate, and the ground to be primed so that growth and change is sustainable and well supported.

Recovery Awareness Reception

Our forthcoming Recovery Awareness Reception on October 2nd will be held in alliance with eating disorder experts, Montrose Manor who are based in Cape Town. With a long-standing relationship in collaboration of care we share similar views about addiction – what it is and how it should be treated – and similar frustrations around how the illness is perceived and therefore treated in the UK.

Charter is predominantly designed as a day programme where people can get well in the context of their lives. This is a deliberate design as those addicts I want to work with are not at the critical end of the continuum (though they may feel it) but somewhere in between, where denial still reigns and trouble usually follows. These people, these addicts, are living amongst us, on the tube, at work; they are serving you, picking up the kids, functioning at some level. These are my clients. I work where intervention happens in time for a full and happy life to be possible.

I believe that abstinence is not the goal, but the means, and thus at Charter we work with each client on the core characteristics of addiction rather than necessarily the drug of choice, reducing the risk of devastating relapse and cross addiction.

Addiction is a human condition, it’s relational and it operates on a continuum. Where you are on that continuum plays a huge part in what sort of treatment you will respond best to. The work we do here is extraordinary, consistently turning out sustainable recovery, as evidenced by our thriving aftercare community. It is possible not only to get clean, but also to live a happy and fulfilling life. Aim for the stars…(and don’t stop flapping your wings ‘til you get there!)

One of the reasons I was interested in hosting this event with Montrose was because we need challenging dialogue amongst the thinkers and decision makers who are interested in this incredibly difficult human condition so that addiction is not marginalised to the confines of the extreme cases, but seen in a broader light, often where an opportunity of early intervention lies. (Is this where I mention being able to spot an addict at age 7…?)

My perspective of addiction by SB Kent

A few days ago I discovered that a childhood friend of mine is an “alcoholic”. His family have been a part of my life forever and as a child I had been envious of the love in their house.  My memories of our families together were always “those were the days!”   I had been oblivious to the destruction that went on around me and as I tick into my 40’s I find myself being less and less tolerant of “the good old days” and start to recognise that there was very little good about any of it.

So here I am looking back at all my friends families that helped define who I am today and I realise that those comfy old rooms aren’t quite as comfy as I recall – the wallpaper is definitely peeling off!  It strikes me that there is no such thing as a functioning family.  Addiction captures every household in some shape or form.  For some it is nothing more than an eccentricity, a foible but for others it is entirely consuming.  We all approach it from a different angle, some of us will choose to ignore what’s happening – perhaps they’ll grow out of it, or they might need to just “get a grip or get out!”  Some of us will want to skirt around the issue and others will want to attack it head on.

But we all have one thing in common – we want change but without change!  We look at the person we love and the addiction we hate, we want to keep the person we love and lose the addiction we hate.  We are united in the terror that in losing the addiction we are also going to lose the person.  And so as they head off toward the first step of change we find ourselves siding with addiction. We become overwhelmingly fearful of change.  We’re so busy looking at who our loved one is going to become in the ensuing weeks, months or even years that we lose sight of who they are in the here and now. We’re terrified that this person who we love and know is going to become a happy-clappy-daisy-chasing-Moonie! Perhaps the drinking isn’t that bad, maybe this relationship will turn them around, possibly a little more time – after all doesn’t time heal? And let’s not hide from the financial aspects of curing addiction, that’s definitely on the list!

Several years ago my younger sister came to me to talk, I had long suspected that her world was spiralling out of control and so was relieved when she told me that she needed my help.  We sat at our kitchen table and she told me that she had regularly been using drugs, she had a serious eating disorder and that she could no longer hide the scars of her self-harming.   Over the next hour or so my relief that she was finally sharing gave way to horror (which I tried desperately to conceal from her).  When she was done telling me her life at that moment she asked “Can you help me?”   I panicked, I had suspected that she might have food issues and I thought she occasionally cut herself but I had always envisaged that when this day came I’d be able to help her out with a cup of tea, a little chat and maybe a visit to the doctor.  This was unbelievably out of my league!  I said the only thing that I could – “No, but I have a good friend who can!”

So in answer to all of the above – yes, my sister changed.  She became an incredible, amazing and beautiful being.  She is still vulnerable yet stronger with it, she still relies on friends and family yet she is independent, she’s accepted what she needs to change in herself and what she can’t change in others.  And she can still party without becoming someone she doesn’t like!

And as ugly as it is, I’m closing with the financial aspect.  The phrase “it never rains but it pours” comes to mind, if any of the above is relevant then let me tell you – right now it’s chucking it down and this is the rainy day you’ve been saving for, so get your feet wet!

Stress and Addiction

The fact that stress is causing an increase in alcohol consumption and prescription/over the counter drug use does not surprise me. Sadly though this is a pattern that becomes increasingly habitual and with trouble usually hot on its heels.  We cannot control what happens in life, but I maintain we are responsible for how we behave in response to life’s curve balls. Drinking or numbing yourself from reality – indeed anything that fosters an attitude of fear, procrastination, deceit and denial – will only delay the inevitable, amplified by that delay.  Drinking should be a pleasure not an escape; prescription drugs should medicate diagnosed mental illness, preferably by a psychiatrist or psychologist; over the counter medications should provide temporary relief for physical symptoms- and counselling provides a forum where you can ventilate your emotions and learn how to live apace with the highs and lows in your life without compromising your integrity – now theres a thought!

Charter gains a touch of Alchemy…

UK’s top Addiction Specialists launch Charter Adolescents

Have communications with your adolescent broken down? Do they seem unhappy or anxious?  Are you concerned they may be drinking or using alcohol or other addictive substances? 

Then Charter Adolescents can help.

Research shows that Adolescents are more vulnerable than any other age group to developing, alcohol and other drug addictions in fact drug use is higher among young people than the adult population as a whole[1], yet there are a lack of specialist facilities to help them.

[1] http://www.homeoffice.gov.uk/publications/science-research-statistics/research-statistics/crime-research/drugs-misuse-dec-1112-tabs/extent-young-tabs

Which is why Mandy Saligari, Founder and Director of leading London addiction facility Charter Day Care, Residential and Counselling Centres has joined forces with Stephen Noel-Hill of Alchemy to form Charter Adolescents.

Stephen has extensive experience working with adolescents and young people spanning twelve years working at the Priory Hospital Roehampton and Adolescent Units in Holland.

Mandy has a well-established presence in independent schools lecturing on addiction, parenting for prevention and self-esteem. She has long since wanted to set up a service especially for adolescents addressing the issues that are brought to the surface in these school talks.

“Adolescents are particularly vulnerable to self-defeating coping mechanisms, our main aim with this service is to encourage a valuable sense of self, working with the young person and their parents – many of whom just don’t know how to cope with the issues their children are raising or the behavior they are presenting.”

Both Mandy and Stephen understand that that early intervention and prevention are fundamental to successful outcomes. It is this common vision that led them to merge Alchemy into Charter.

Charter Adolescents is an exciting new service that will do what Charter does best: intensive non-residential treatment and multi-disciplined counselling and therapy. The focus is on early intervention, education, emotional development and appropriate referral to give the adolescent and the family a new lease of life.

With a counselling team who are specialists in this area and experienced in work with young people, alongside Stephen’s expertise and Mandy’s guidance, this service will be dedicated to young people.

Working in groups, individual and family sessions and workshops, after school hours and at weekends, Charter Adolescents is an intensive and brief intervention and counselling service targeted to work with addictive disorders and emotional disturbance.

Charter is well established as a leading London addiction facility offering focused, flexible and effective day care for all addictive disorders at competitive rates.

For more information visit www.charterdaycare.com or call 020 73234970 or email  info@charterdaycare.com

Charter Day Care, 15 Harley Street, London W1G 9QQ


Press Information

Addiction Experts, Spokespeople, Advice Columns, Latest Research, Case Studies and Images available.

Enquiries: Jenny Rose, jenny@happypr.co.uk M: 07957 551 697.







My son introduced me to a movie last night called Repeaters about 3 addicts in rehab on Step 9. It was brilliant and displays a real understanding of recovery. I found it both shocking (possibly because I  was watching it with my son) as well as deeply reassuring and exciting that such a clear interpretation of Step 9 is out there from mainstream Hollywood – and WATCHABLE, gripping even! I won’t say much more apart from advice NOT to watch it if you are in early recovery as may well trigger craving…but otherwise it was brilliant.

Parenting for Prevention Workshops

I have been presenting Parenting for Prevention workshops in schools across the UK for around 10 years and am now planning to bring this material into the treatment environment as a workshop targeted towards helping parents whose children suffer from addiction.

Every parent with a child of any age who is acting out in an addictive way needs to be aware of their boundaries, be able to present a consistent response to any demand or behaviour, and to feel that their decision is seated in respect and self esteem.

I often get asked where the line is drawn between good parenting, ie the duty to love, guide, punish and teach, and unhealthy enmeshed parenting where there is often an over involvement and overt sense of responsibility and resentment. Although the age of the child is relevant in this discussion, the core principles are the same and a big question is who is in charge?

In a family where addiction is present it can often appear as if the addict is running the show, able to hijack any interaction or event and frequently create worry and drama. But of course it is not the addict per se, it is addiction itself that is operating within the family system. Once parents and family members start to behave in a coordinated and healthy way, changes always happen.

This workshop is specifically designed to illustrate adolescent reactions that can feed conflict and splitting which are instantly recognizable. There is usually a lot of laughter in this workshop before parents get down to working on understanding and then practicing the simple responses that can make all the difference.

These patterns always exist in addictive relationships and it is vital that those close to the addict know how to navigate them, to feel confident that they are supporting the solution not feeding the problem.

Please contact the office if you are interested in attending any of our workshops in the future: 020 7323 4970

Family Groups

Family Group is a very important part of Charter’s addiction treatment programme.  Currently costing just £150pa per family member for unlimited access, the groups provide an introduction to addiction and vital peer and counselling support for family members of an addict.

The familiar position of lose:lose is the domain of the families of addicts, where it is so hard to know what to do as your loved one perpetually holds the proverbial gun to their own head and, finger on trigger, reacts what you say and do.

At Charter we advocate re-establishing a sense of nourishment and self respect in the family member so that they too can make a decision instead of just reacting to a situation:- fire fighting. This takes time and commitment and I am proud to say that we have a core group of hard working family members cementing the changes with their increasing understanding and personal growth. When one person changes, the dance changes. So whether your addict is on board (yet) or not, working in the family group can make all the difference to the possibility and nature of recovery in your life.

We also hold family workshop weekends that provide a more intensive introduction to letting go with love, enablement vs tough love and how to take care of you – many family members recoil from such apparently new age statements (as did my own parents many years ago) – but these workshops have proven to be of fundamental use to those struggling to gain purchase on this slippery and destructive condition in the life of someone they love.

Addiction is all consuming, self centred, provocative and relentless. It takes experience to know how to behave around it, and courage and compassion not to feed it.  The group will support you while you learn…

UK cyclist Bradley Wiggins admitted to a history of binge drinking

I am over the moon that UK cyclist Bradley Wiggins admitted to a history of binge drinking yesterday as the shame that surrounds addictive patterns prevents people from seeking help. The more people of note speak up the less humiliating it should be to admit a problem.  Thank you Bradley for your courage and integrity.

Sadly though my guess is that the interested population will be more likely to line up their next pint ‘just one more before I do the tour, mate’ than to shake their head amidst roars of bullying derision with ‘no thanks, mate, I’m going to see if I can stop’.  Such is the grip alcohol has on our society that even with evidence of damages caused by binge drinking (conservative estimates rate at over one person a day to die from alcohol over the next 20 years) and with 1.5million UK dependent drinkers of which only 8-18% are in treatment, our culture continues to neck alcohol in huge proportions, becoming a European leader in alcohol consumption. The prospect is not good.  Alcohol damages must not only be measured in terms of the direct hit to the drinker (physical, emotional, mental, financial), but to their families, to their social context, to their work, to our social services, our police, our NHS – to each and every one of us intimidated or harmed by someone under the influence. Of all those drinkers too, many have families, and the children of these unions of active addiction grow up to become Adult Children of Alcoholics – a self destructive legacy all of its own.

The cost is far too high and the justification to drink is that of an addict. I am a supporter of early intervention, of treatment, of minimum pricing and of education – to children and their parents. We must start with the parents…

(The statistics cited have been taken from Druglink Magazine, May/June 2012).