Discrimination Through Denial of Coverage
Health insurance is probably going to be one of the great debates of this period in American history. There is already plenty of contention about how to properly provide coverage for those who need it. Some claim the changes made in the last decade have gone too far. Others argue it has not gone nearly far enough. Healthcare reform is a hot button issue in our world today. Needless to say, a big part of this conversation has to do with parity coverage for mental health. Now a new landmark court ruling is going to make a monumental difference for mental health and addiction treatment insurance coverage.
Simply put, the largest behavioral health care company in America has been denying coverage to some of its most vulnerable members to save money. And now, a federal court decision may put more of a spotlight on insurance companies.
Wit v. United Behavioral Health
The case was brought in front of a federal court in Northern California against United Behavioral Health (UBH). UBH is a company that manages behavioral health services for UnitedHealthcare and other health insurers. The court found that UBH denied claims of tens of thousands of people seeking mental health and substance use disorder treatment. The company was using defective medical review criteria in order to reject claims.
In Wit v. UBH, over 50,000 individuals were reportedly denied coverage based on the flawed review criteria. 11 plaintiffs sued UBH on the behalf of these victims. One victim, in particular, is Natasha Wit. Natasha had been seeking treatment for several chronic conditions, including:
Wit was repeatedly denied coverage for her treatment, despite the fact she did have healthcare benefits that should have offered coverage. Her family ended up paying out nearly $30,000 for treatment. And they are just one of the thousands of families to face the same discrimination.
Looking at the Marks Against UBH
According to recent reports, United Behavioral Health has been failing its members in more ways than one.
Federal courts determined that UBH developed internal guidelines that were “unreasonable and an abuse of discretion” and “infected” by financial incentives designed to restrict access to care for those who should qualify for coverage. Essentially, UBH was manipulating internal guidelines to avoid providing coverage that members had every right to under the law.
For many of those struggling with substance use disorder, defective criteria for coverage can equate to a death sentence. When looking over the requirements set by UBH, it is no wonder why the courts say they are illegitimate.
Firstly, their medical-necessity criteria fail to provide coverage to those chronic and comorbid conditions. Generally accepted standards of care state these conditions should be effectively treated, even when those conditions:
- Respond slowly to treatment
- Require extended or intensive levels of care
However, UBH set guidelines that only approve coverage for what they labeled “acute” episodes or crises. For example, only individuals who were actively suicidal or suffering from severe withdrawal could be considered for coverage.
In other words, for someone who struggled with substance use disorder or mental illness, you had to be knocking on death’s door to get a chance at treatment. The court found that these guidelines were not acceptable.
Furthermore, UBH fails to use national evidence-based guidelines for covering different levels of care for mental health and substance abuse treatment, such as:
These are guidelines that have been developed by clinical specialty nonprofit organizations.
Additionally, UBH’s guidelines improperly required reducing the level of care, even if the providers who were treating them recommended maintaining a higher level of care. So patients would be removed from more intensive residential treatment programs and pushing into some form of outpatient therapy, even if the specialists argued that they were not ready.
This is a big deal. Most recovery advocates and healthcare providers agree that insurance companies should not be the ones telling treatment providers how to care for their patients.
State Mandated Guidelines
Furthermore, some states have mandated specific guidelines for evaluating the medical necessity for behavioral health services. UBH was also found to have violated these requirements for reviewing substance use disorder claims as well.
The case against United Behavioral Health was filed under the Employee Retirement Income Security Act of 1974 (ERISA). This is a federal mandate that governs group health insurance policies through private employers. More specifically, ERISA requires insurance plan administrators to function in a fiduciary capacity when overseeing employee benefit plans. This includes coverage for mental health and substance use disorder treatment.
In Wit v. UBH, the court determined that UBH was in breach of its fiduciary duties by developing and employing faulty medical necessity criteria for behavioral health services. Therefore, the court alleges that UBH is in violation of its obligations under this federal law.
What Does this Mean for Addiction Treatment Insurance Coverage?
This case is exposing insurers for refusing care to people at serious risk of death by overdose or suicide. It is important to remember that UBH is not the only insurance provider trying to find ways around federal and state coverage guidelines. Given the nature of these violations, advocates believe that regulators should immediately start examining the market conduct of all healthcare plans across the country.
Judge Joseph C. Spero in Wit v. UBH also points out that the company was circumventing the Mental Health Parity and Addiction Equity Act of 2008, also known as the Federal Parity Law.
Parity law actually requires insurers to cover illnesses of the brain, such as depression or addiction, the same as illnesses of the body, such as diabetes or cancer. In his ruling on Wit v. United Behavioral Health, Judge Spero highlights an abundance of evidence that guidelines created by the UBH were designed to diminish the impact of the 2008 Parity Act in order to keep benefit costs down. In other words, it is clear that the company was actively trying to work around federal law in order to avoid providing coverage to people with mental illnesses and addictions.
For those in the mental health and addiction communities, this brings new awareness to the discriminatory practices of treating mental health conditions differently than physical conditions. The new hope is that insurance providers will understand the consequences of discrimination against those who need help. With so much going on in healthcare, the Federal Parity Law must be protected.
Far too many people suffering from mental health and substance use disorders never get the help that they need. The last thing we need in a country devastated by an opioid crisis and rising overdose death rates is to create more roadblocks to treatment resources.
Palm Healthcare Company believes that if our country is ever going to overcome the damage of the opioid epidemic, we have to offer more comprehensive treatment options to those who still suffer. Insurance companies should not be keeping people from the care they deserve. Prevention is important, but we also believe in taking care of those who are already in the grips of substance use disorder by offering compassionate and effective care. If you or someone you love is struggling, please call toll-free now. We want to help.
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When they hear the words “sex addiction” most people probably have a similar, simplistic assumption of what that means. They will picture someone who has sex a lot throughout the day, or maybe someone who has a lot of sexual partners. Some people associate it with over-indulging in pornography or engage in an inappropriate sexual behavior.
However, these are not necessarily the defining features of sex addiction. Not everyone who suffers from it will have multiple partners, and they most certainly don’t all act out inappropriately. While some of these scenarios may be present in those who experience sex addiction, many advocates believe the vital element of sex addiction has to do with the consequences of their behaviors and their inability to control them. Other terms for sexual addiction include:
- Hypersexual Behavior Disorder
- Sexual dependency
- Compulsive sexual behavior
It is also known as nymphomania in females and satyriasis in men. So what is sex addiction, and can it be treated?
The DSM Debate
The most difficult part of the conversation is trying to talk about what sex addiction actually means when it is not officially recognized as a mental health disorder.
One of the most essential tools we use for understanding and treating mental health is the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is a widely recognized compendium of mental health diagnostics. This crucial resource receives regular updates from the American Psychiatric Association (APA).
At this point in time, the DSM does not include criteria for sex addiction. Among mental health professionals in the APA, this is the cause of a great deal of debate. For a quick timeline:
(DSM-III-R), referred to “distress about a pattern of repeated sexual conquests or other forms of non-paraphilic sexual addiction, involving a succession of people who exist only as things to be used.” The reference to sexual addiction was subsequently removed.
The DSM-IV-TR did not include sexual addiction as a mental disorder.
Some authors suggested that sexual addiction should be re-introduced into the DSM system; however, sexual addiction was rejected for inclusion in the DSM-5, which was published in 2013.
Darrel Regier, the vice-chair of the DSM-5 task force, stated:
“Although ‘hypersexuality’ is a proposed new addition… [the phenomenon] was not at the point where we were ready to call it an addiction.”
The proposed diagnosis does not make the cut as an official diagnosis due to a lack of research into diagnostic criteria for compulsive sexual behavior, according to the APA.
As of 2017, none of the official regulatory bodies for Psychosexual Counselling or Sex and Relationship therapy, have accepted sex addiction as a distinct entity with associated treatment protocols.
The World Health Organization produces the International Classification of Diseases (ICD), which is not limited to mental disorders. The ICD-10 includes “excessive sexual drive” as a diagnosis (code F52.7), subdividing it into satyriasis (for males) and nymphomania (for females).
However, the ICD categorizes these diagnoses as “compulsive behaviors” or “impulse control disorders” and not specifically addiction.
The most recent version of that document, ICD-11, includes only “compulsive sexual behavior disorder” as a diagnosis, but does not use the addiction model.
Opposing Expert Opinions
Some opposing it believe that it is an agenda put forth by “sex-negative” clinicians trying to control the private behaviors of their patients. Indeed, some practitioners regard sex addiction as a potentially harmful diagnosis. Some even draw parallels with controversial gay conversion therapy that has caused a great deal of outrage over the years.
Of course, this is an understandable reservation to have. No one should be made to feel that their sexual preferences are an illness. So the debate is not an easy one to solve. When does one draw the line and say what should be considered “healthy” sexuality? In the end, some do fear that having a sexual addiction classification will make problems out of nonproblematic experiences.
However, there are still many experts and mental health professionals advocating for the inclusion of sex addiction as an official psychiatric condition. Many therapists and psychiatrists say that excluding sex addiction from the DSM completely disregards the pain, confusion, trauma, fear, and hopelessness of sex addicts and their families.
What Advocates Consider Sex Addiction
Even though there are no official DSM criteria for sexual addiction, provisional diagnostic criteria for sexual addiction that follow DSM format have been derived from DSM-IV-TR criteria for substance dependence.
According to Aviel Goodman, MD, sexual addiction is a maladaptive pattern of sexual behavior that leads to clinically significant impairment or distress, as manifested by at least 3 of the following within a 12 month period.
- A distinctly increased amount or intensity of the sexual behavior to achieve the desired effect or markedly diminished effect with continued involvement in the sexual behavior at the same level of intensity.
In other words, needing more in order to feel something. This is often seen in relation to substance abuse when people develop a tolerance to a drug over time.
- Characteristic psychophysiological withdrawal syndrome. When someone discontinues a sexual behavior and experiences
- Physiologically described changes
- Psychologically described changes
- The sexual behavior is often engaged in over a longer period, in greater quantity, or at a higher level of intensity than was intended.
- Persistent desire to engage in sexual behavior and being unable to control the sexual behavior.
- Excessive time is spent on activities necessary to prepare for the sexual behavior, to engage in the behavior, or to recover from its effects.
- People reduce or discontinue important social, occupational, or recreational activities because of the sexual behavior.
- The sexual behavior continues despite knowledge of the harmful consequences of the behavior.
This outline is not the final word on sex addiction. It is possible that our understanding of sex addiction will evolve as research grows. For now, this is a starting point to better understanding how sex addiction impacts people.
What Sex Addiction Is NOT
Due to there being no clear-cut definition of sex addiction, there are also those who mislabel certain behaviors. While everyone may not agree on sexual addiction as a condition, those who do typically agree on what is NOT sex addiction. Most notable examples are the controversies surrounding allegations of sexual misconduct and how certain individuals have used sex addiction as an alibi for inappropriate sexual activity.
Also, some people may be mislabeled by others as sex addicts because of their preferences. However, this is also incorrect. It is significant to point out that no form of sexual behavior in itself constitutes sexual addiction. A pattern of sexual behavior does not qualify as sexual addiction based on things like:
- The type of behavior
- The object of the behavior
- Social acceptability
Sexual addiction is determined by how it impacts the individual’s life. Essentially, any sexual behavior has the potential to be engaged in addictively. That does not make the behavior itself inherently wrong. Again, we reiterate that the key features distinguishing sexual addiction from other patterns of sexual behavior are:
- The inability to control the sexual behavior reliably
- Continuation of the sexual behavior despite significant harmful consequences
There are plenty of situations where people find it very difficult to determine what constitutes a sexual addiction and what does not.
A great example of a circumstance that isn’t so black and white is paraphilia.
Paraphilia is a condition where people have sexual desires that typically involve extreme or dangerous activities. Again- this is another term that causes contention because some people label the behavior as abnormal, while others say it is simply a fetish. The symptoms of sex addiction and paraphilia overlap to some extent, but they are not identical. Some sex addicts are not paraphiliacs, and some paraphiliacs are not sex addicts.
A similar distinction exists between a sex addict and sex offender, where the area of overlap is considerably smaller. However, this does not mean the behaviors of a sex offender are justified by sex addiction.
Sex Addiction Treatment
After all that, we have to ask- can sex addiction be treated? According to an article published on healthresearchfunding.org, an estimated 12 to 30 million people in America experience sexual addiction. So do they have opportunities to get help?
This is why it is important to have more research on sex addiction so that more can be done to create better opportunities for treatment. For now, some people find a great deal of help utilizing the same concepts presented in substance abuse treatment. Most people who do get help for sex addiction receive help from addiction professionals.
Current treatment options aim to reduce any excessive urges and to encourage the nurturing of healthful relationships. An important element in treating sexual addiction is not to shame people for their preferences or their experiences and try to help them design a personalized recovery plan that will help them have a happier and healthier life. A lot of people who get treatment for sex addiction do find help with options such as:
Residential treatment programs
Residential treatment programs exist to help individuals struggling with various addictive disorders. These are in-patient programs where individuals live on-site at a facility while receiving direct care from specialized therapists in a safe and controlled environment.
Cognitive behavioral therapy (CBT)
Many programs that work to treat sexual addiction provide cognitive behavioral therapy. This comprehensive approach gives people a variety of techniques that help the individual change their behavior. CBT can equip a person to avoid relapses and reprogram harmful sexual behaviors by helping them recognize patterns and develop healthier coping skills.
Beyond traditional addiction treatment options, there are always self-help organizations and support groups. Numerous 12-step programs offer to help the individual in self-managing their sexual addiction, including:
- Sex Addicts Anonymous
- Sexaholics Anonymous
- Sexual Compulsives Anonymous
- Sex and Love Addicts Anonymous
For some, sex addiction goes hand-in-hand with a substance use disorder, such as alcoholism. In cases like this, medical detox is always a good idea in order to get professional support through the initial process of withdrawal. Also, it is important for those struggling with co-occurring disorders to consider dual diagnosis treatment in order to address both issues for a stronger foundation for recovery.
Despite the debate about how sexual addiction should be classified, the reality is that a lot of people have seen the damage done to their lives as a result of their behaviors. So without trying to punish the sexuality of an individual, there should be resources available for those who want help. If you or someone you love is struggling with an addiction, please call toll-free now.
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Most people in the world would say that nothing is more important than family. They say that you can choose your friends, but family is forever. If you subscribe to the philosophy of blood being thicker than water, then it makes sense that when those closest to you suffer, you suffer right along with them. For many, this concept is never more painfully clear than when living with an addict in the family. Even though plenty of people struggling with addiction say they are only hurting themselves, most of us know that addiction is a family disease.
While there are many obvious ways that addiction affects a family, like domestic violence, financial troubles or death, there are also some more subtle consequences. When someone is suffering, their loved ones will often develop specific family roles for dealing with addiction. Depending on the household, and how the addiction manifests itself, some people may take on multiple roles in order to try and create a balance at home. However, many of these family roles can cause adverse effects of personal development over time.
Here are 6 family roles people use when coping with addicted loved ones.
Addiction and its effects draw a lot of attention, so it may seem to the addict that the world revolves around them. They take on a victim mentality, often causing others in the family to feel the need to save them, or at least to avoid disturbing them.
The victim is central to all the other family roles that develop around it. As the roles are defined, the victims loved ones unconsciously take on other family roles to complete the balance after the problem has been introduced.
Although this person’s actions are the key to their own recovery and overcoming the victim mentality, it is important to remember they are not necessarily vital for a family to recover on its own.
In the family, there will be someone who tries to be the champion for the victim and the family. This is someone who needs the family to look good, and they will work hard to make it so. The problem with the Hero is that they try to ignore the addiction and its effects. Instead, they want to dress everything up and act as if all is well.
The Hero will present things in a positive manner as if the family roles don’t actually exist. They are often perfectionists and overachievers, who seek to unite the family and offer hope through their own accomplishments. But taking on all this pressure can cause a lot of stress and anxiety for this family member. Very often this is the child of an addict or alcoholic.
If the Hero is able to finally overcome this role, they can ultimately play a crucial part in the addiction recovery process, both for the individual and for the family.
The Mascot’s is often thought of as the comic relief. This is the member of the family who uses humor as a defense mechanism and a distraction tactic. They try to soften the impact of an addicts behavior or ease tensions between family roles through laughter.
On the bright side, the Mascot does bring humor to the family roles people use for coping with addicted loved ones. They have a talent for making others feel better, even in the worst situations. But ultimately, they are also people-pleasers to a fault, which can foster feelings of anxiety.
However, Mascots sometimes make inappropriate jokes about other family members or situations, which can causes friction. They also run the risk of avoiding their own feelings or being inconsiderate of the feelings of others. Sometimes their harmful humor can hinder addiction recovery.
Also, the Mascot is likely to self-medicate as they grow up, perpetuating the cycle of addiction.
The Lost Child
In every family that deals with an addicted loved one, there is usually someone who tries their best to disappear. They are silent, withdrawn, and avoid drawing much attention to themselves from other members of the family. This is the Lost Child.
The Lost Child is typically careful to not make problems. They avoid any kind of conflict, along with conversations regarding the addiction or the underlying family roles that take shape around the victim.
The Lost Child will spend as much time as possible in isolation or away from their family. They are the child who sits in their room playing video games or watching TV for hours without any interaction. The Lost Child will often develop feelings of neglect and resentment, which can lead to depression. They often grow up to have a very difficult time developing healthy relationships later in life.
The Scapegoat is a problem child. Usually, this is the black sheep of the family who often acts out in front of others. They take on this role, knowingly or subconsciously, to divert attention from the person who is addicted. They rebel home, get in trouble at school, make a lot of noise to mask the underlying issues in the family. Male scapegoats are often prone to violence, while female scapegoats frequently act out sexually.
This person may even adopt substance use in order to run interference for a parent or sibling. They may develop other issues as well, such as eating disorders or a tendency to self-harm.
The Scapegoat covers or draws attention away from the real problem. They grapple with feelings or anger and shame, and they often offer the other family roles a sense of purpose- being someone to watch out for or try to fix.
The Enabler is also commonly referred to as the Caretaker but is always the person who makes all the other family roles possible. Most often this is a spouse, but it can also be a child of an addict.
Caretakers will take it upon themselves to keep everyone happy, believing it is the best way to protect the family. Their mission is to maintain balance in order to make the family look good on the outside. They are notorious for minimizing the addiction, making excuses for all behaviors and actions. They have a knack for blaming everything on something else, without acknowledging the real problem.
This person protects the addict from consequences, while constantly cleaning up after their messes.
Additionally, the Enabler frequently embraces the other family roles when they are convenient for maintaining the family balance. They will laugh at the Mascots harmful jokes, or adamantly put the focus on the Hero’s achievements. They will support the Lost Child’s “independence”, and run interference for the Scapegoat, all while catering to and caring for the needs of the victim.
At the end of the day, the family roles people adopt as part of coping with an addicted loved one are a kind of functional dysfunction. It is a system that people create in order to survive situations at home that can be toxic and unpredictable. Human beings by nature will behave in accordance with their surroundings. Out of self-preservation, we will get used to unhealthy strategies for dealing with unhealthy relationships. Even if they are not effective, if they help us get by there is a lot of damaging stuff we will get used to.
All of these family roles demonstrate how important it is for families to be supported and involved in a loved one’s recovery from addiction. Because we can see how addiction impacts the family, we know that the family also needs help in overcoming those adversities. Having a recovery program designed specifically for family members and loved ones of people with addiction can make all the difference. Not only does it help the family support their loved one, but it helps the family recover on its own. Family can also play a very important role in relapse prevention. It teaches them what their loved ones may experience during the medical detox phase of treatment. It helps them better understand the science of addiction and the process of recovery, while also showing them how their own behaviors have an impact.
The Palm Healthcare Family Program is all about helping the family come together to face addiction and overcome all the unique challenges that come with it. If you or someone you love is struggling with addiction, please call toll-free now. You are not alone. We want to help your family be stronger together.
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By: Thomas G. Beley, PhD, LCSW
There is a German fable that states that relationships are like two porcupines trying to keep warm in the dead of winter. Move in too close, or too quickly, in the anticipation of feeling the warmth, chances are the porcupines are going to experience some discomfort and pain from their respective ill-positioned quills. Yet, being afraid of getting too close to each other, the porcupines are likely to run the risk of dying from the winter cold.
As individuals, our relationships are not too different than the porcupines. Whether it is with family, friends, co-workers or strangers, we are constantly in a natural process of trying to determine just how close we need to be with someone while at the same time not sacrificing our own individual beliefs, values, or needs. It is the negotiation of these two natural forces of individuality and togetherness that determines the success of any relationship. Too much of either or an imbalance can have unsettling effects.
It is important to understand that individuals are subject to an inherent process of trying to reach a successful balance between these two natural forces. Research has shown that this is a process rooted in nature and all living organisms. Being a part of all life means we have the desire to be our own person yet at the same time desire the safety and security of the group.
Finding Balanced Relationships
In humans, this process happens both consciously and unconsciously. We seek out relationships that will give us both the opportunity to pursue our own individual needs while at the same time involve ourselves in a relationship that is nurturing and comforting. Our behavior, whether good, bad, or indifferent, is often influenced by these forces of nature of trying to find that right balance between one’s need for individuality and togetherness. The successful balance of these two life forces is what brings us a sense of well being and contentment. It is our ability to maintain this delicate balance between individuality and togetherness that determines the quality of any given relationship.
It is also important to note, here, that the quest for individuality or togetherness is not to say that one is more important than the other. They are both extremely critical. However, it is how a person balances these two forces within their life and the relationship systems in place that makes the difference between staying calm and collected and being in a state of turmoil and conflict.
Relationship conflicts often occur when there is an imbalance in these two natural forces. Imbalances can occur both within the individual and within the relationship system itself. A common scenario that often develops is when one person within the relationship system desires more individuality and the other person in the relationship system desires more togetherness and closeness. As is often the case, one person begins to feel overwhelmed in the relationship while the other person may feel neglected. Typically, the person desiring more individuality is running away from the relationship system while the person seeking more closeness is chasing the relationship system.
The Dance of Conflict
This “dance” can occur in a variety of ways. One such way is when an individual requires an excessive amount of one or the other. Too much of an individuality influence may make it difficult for that person to make a meaningful connection with others, particularly those who desire more closeness and togetherness. In that desire to achieve a sense of individuality, a person can easily cut him or herself off from others. Along the same lines, a person with a high degree of individuality may find others having a difficult time making a meaningful connection with him or her. The same holds true for the person needing a great deal of togetherness. The desire to achieve closeness can result in the person becoming excessively dependent on others or not maximizing their own individual potential.
Another common scenario that is when one person desires individuality and the other person is requiring a sense of togetherness. A person who requires a sense of individuality will likely create a conflict in the relationship system of the person who has the desire to achieve more togetherness. The same dilemma holds true if two people have inordinate amounts of the same needs. Two people desiring a great deal of individuality will likely experience the cold of winter. Two people desiring a great deal of togetherness will likely feel the quills of another person. When there is an imbalance of these needs, anxiety occurs and the potential for conflict exists.
Find What Matters
It is important to emphasize that there is no magic formula that constitutes what is the right amount of togetherness or individuality within a relationship system. What truly matters is how a person manages their respective needs and the awareness of the needs of the other within the relationship system.
Doctor Thomas G. Beley, Ph.D., LCSW is the Executive Director of Palm Healthcare Company. For over 25 years, Doctor Beley has worked in the field of substance use disorder and mental health disorders. Through the years of helping people who struggle with drugs, alcohol and mental health issues, Doctor Beley has proven to be an expert clinician and an innovative and compassionate leader in the treatment industry. Palm Healthcare Company is grateful to have an executive team with experience and incredible commitment to helping others. If you or someone you love is struggling, please call toll-free now. We want to help.
CALL NOW 1-888-922-5398
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One of the most harmful myths about alcoholism that needs to be debunked is the idea that drinking does not affect anyone but the individual. People tend to be self-centered when lost in their cups, and so many believe the only person who has to deal with their drinking problem is them. No one else has to spend the money, or feel the hangover, or suffer the consequences… right?
But we know this isn’t true. The behavior of an alcoholic or a drug addict impacts others, especially the people closest to them. An alcoholics family can experience a great deal of pain and carry plenty of consequences as the result of their loved one’s drinking.
However, none are as vulnerable as the children of alcoholics. Frequently, the impact of parental alcoholism on a child can last the rest of that child’s life. Even as children, they may do their best to conceal the effects at the time, but one way or another it always leaves a mark. Here are just some of the ways that parental alcoholism affects children.
One way parental alcoholism affects children is by creating a lot of self-doubt and self-criticism in many children. Often, the children of alcoholics believe their own shortcomings are the cause of disturbances in the home. This can lead them to be extremely critical of themselves. They may believe they are not good enough, and frequently develop low self-worth and low self-esteem.
Even as adults, the children of alcoholics can feel inadequate.
Over time, the tendency to doubt themselves and be so critical can lead to other issues, including depression and anxiety disorders. Parental alcoholism can lead a young child to feel like they are unworthy or responsible for more than is actually under their control.
Fear or Abandonment
In most cases of parental alcoholism, the parent is emotionally unavailable or even physically not around. Sometimes a parent will be asked to leave due to their drinking by the other parent. Other times, the parent will get in trouble with the law and may go in and out of institutions. In some cases an alcoholic parent will have to be hospitalized, or even worse, they pass away.
All of these circumstances can lead the child of an alcoholic to develop a deep fear of being abandoned. Losing a parent, even if only periodically, can be devastating for young children.
When a child has developed low self-worth, is extremely critical of themselves and has a fear of being abandoned, it only makes sense that they will constantly seek approval from others. Growing up in a house with parental alcoholism as the norm, a child always trying to make others happier will become a people-pleasing adult.
This can be especially true if a child’s alcoholic parent was mean or abusive when they were drunk. It can intensify the fear of not being enough, or of being abandoned. As an adult, the children of alcoholics can grow up with a fear of confrontation. They may spend their lives avoiding any form of conflict. Furthermore, a child of an alcoholic might even sacrifice their own well-being in order to avoid making others angry.
Sadly, with people pleasing a child will learn to suppress their own emotions, making them an emotionally stunted adult.
Sometimes, the child of an alcoholic is so committed to people pleasing that they become a perfectionist. Parental alcoholism can cause a kid to become incredibly responsible, hoping to gain some control of the world around them. These children of alcoholic parents become overachievers or workaholics.
However, there is no guarantee that they will not try to overcompensate in the opposite direction. An alcoholic’s child may also become very irresponsible members of society. They may adopt a self-destructive lifestyle similar to their parents in order to try and escape the pressures of an alcoholic home. Thus, the cycle continues.
If parental alcoholism has played a key role in the household, it is hard for a child to determine what “normal” is. This inability to distinguish the good from the bad makes it much more difficult for children to decide which role models to follow. Not only that, it makes it hard to know the right way to treat other people.
If you grow up in a home where abuse and alcoholism are normal, you are likely to engage in that behavior and seek out relationships like that later on in life. By normalizing the harmful behaviors and the toxic relationships that a child of an alcoholic can be exposed to, they are also building a faulty foundation for future relationships.
Difficulty with Relationships
When growing up with parental alcoholism in the home, kids will experience things like:
Sadly, they may accept that these things are all normal. Thus, these children can develop severe trust issues. If you have grown up developing serious trust issues and/or a lack of self-worth, getting close to anyone can seem almost impossible.
In order to be intimate with others, you have to rely on others for emotional attachment, fulfillment, and interdependence. These things can be very hard to reconcile for the child of an alcoholic home. And if you are so critical of yourself, a strong fear of abandonment will definitely be very hard to overcome when trying to build relationships. Pretty much every issue we mentioned before this point makes it extremely difficult for these children to have healthy relationships.
Overcoming Parental Alcoholism
In truth, there are innumerable ways that parental alcoholism could affect a child. Because we are always trying to figure out what things mean as children, we could adopt completely different ideas based on a variety of experiences. Some people are more sensitive to certain kinds of problems, while others may use their bad experiences as motivation to set better standards for themselves. In short, not all children of alcoholics will be affected the same.
However, many of the issues on this list appear consistently in studies of adult children of alcoholics. For years, these are some of the most common characteristics identified in research on the families of alcoholics. Regardless, one thing remains the same- parental alcoholism can significantly influence a child’s development. Time and time again, we can see how the impact of growing up with parental alcoholism can shape an adult.
A large proportion of the people who seek help for substance use disorders like alcoholism or drug addiction have kids. Sadly, a large number of parents do not seek help because they are afraid of being away from their children. Some even worry they may lose their children. Still, every year countless children lose their parents to alcohol and drug use. That is why it is so important that parents and caregivers receive comprehensive and compassionate support in holistic addiction treatment.
If you or a loved one is looking for treatment, make sure the program you choose has ways for the family to be involved in the recovery process. Not only is it good for helping people understand what their families go through, but they also teach families about what the suffering individual goes through.
Treatment for alcoholism or addiction is not about taking families apart, but about bringing them together.
Palm Healthcare Company believes in uniting loved ones through the practice of healing mind, body and spirit. Our holistic addiction treatment program gives each individual an opportunity to create a personalized recovery plan that helps them to overcome their addiction and get back to what matters most. If you or someone you love is struggling, please call toll-free now.
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Anthony Michael Bourdain, born June 25, 1956, was a man with a rich and vibrant legacy. He took us on exotic adventures to explore the world and tried to expand the view of the audience on culinary arts and culture. He was much more to so many than a celebrity chef.
Anthony Bourdain was an author, travel documentarian, and television personality. He used programs like A Cooks Tour and No Reservations to travel across the globe, focusing on the international culture, cuisine, and the human condition. He has sat down for humble lunches with President Obama, and his explosive personality has even been featured in cartoons like The Simpsons and popular FX series Archer. Bourdain has taken us to some of the most secluded corners of faraway places to chat with the locals and enjoy a simple dessert. Anthony Bourdain was widely regarded as one of the most influential chefs in the world.
On June 8th, 2018 the world was shocked to hear that Anthony Bourdain had died at 61 years old. Even more heartbreaking was to learn his death was a suicide. Over the last several days, his passing has sparked a continuous stream of dialog about mental health and the need for treatment resources. Over the years the famous traveling chef fought against drugs like heroin, as well as depression. As we remember who Anthony Bourdain was, and as we call for letting go of stigma and pushing forward with helping those in need, it is important to look at the whole story.
Anthony Bourdain first fought his way up the kitchen ladder in New York to become a long-time chef at Brasserie Les Hallas. Around this time, he wrote his breakthrough memoirs titled Kitchen Confidential: Adventures in the Culinary Underbelly, which took him beyond the cutting boards to carving his way through the literary map.
Part of this first memoir describes the long journey that brought him to become a chef, and a notable element of his story is extreme excursions into drugs, strung out over years. In the book Kitchen Confidential he wrote about his experiences back in 1981 working at a restaurant:
“We were high all the time, sneaking off to the walk-in refrigerator at every opportunity to ‘conceptualize.’ Hardly a decision was made without drugs. Cannabis, methaqualone, cocaine, LSD, psilocybin mushrooms soaked in honey and used to sweeten tea, secobarbital, tuinal, amphetamine, codeine and, increasingly, heroin, which we’d send a Spanish-speaking busboy over to Alphabet City to get.”
Later, Bourdain became more open about discussing his drug use. He’d even said some of these problems should have killed him in his 20s. In 2014, he did an episode of his show Parts Unknown that highlighted the ongoing opioid epidemic in Massachusetts. During the episode he says,
“Somebody who wakes up in the morning and their first order of business is (to) get heroin — I know what that’s like,”
Parts Unknown went on to be honored with five Emmy awards.
Eventually, Anthony Bourdain found himself kicking heroin in the 80s in drug rehab. When talking about finally getting clean he said,
“And we’re the lucky ones. We made it out alive. There are a lot of guys that didn’t get that far. But you know, I also don’t have that many regrets either.”
However, he admits to still worked long hours in New York kitchens interspersed with binges that consisted of cocaine and alcohol. Following rehab that Bourdain had cleaned up his act, although he continued drinking alcohol. He later wrote,
“Most people who kick heroin and cocaine have to give up on everything. Maybe because my experiences were so awful in the end, I’ve never been tempted to relapse,”
On June 8, 2018, Bourdain was found dead of an apparent suicide by hanging in his room at the Le Chambard hotel in Kaysersberg, France. At the time he had been traveling with friend Éric Ripert. Ripert reported that he became worried when Bourdain missed dinner and breakfast. According to the public prosecutor Christian de Rocquigny du Fayel, Bourdain’s body showed no signs of violence. At this point there has been no official word on toxicology tests to determine whether drugs or medications were involved in his tragic death.
It is hard to put into words the life and legacy of a man as dynamic as Anthony Bourdain. He wasn’t just a face on TV, he was a voice trying to tell us to embrace more of the delicious variety in life. It is easier to just look at some of his many accomplishments. Bourdain wrote multiple bestselling nonfiction books over the years, including:
- Kitchen Confidential: Adventures in the Culinary Underbelly
- Medium Raw: A Bloody Valentine to the World of Food and the People Who Cook
- A Cook’s Tour: In Search of the Perfect Meal
- The Nasty Bits
His articles and essays appeared in many publications, including:
- The New Yorker
- The New York Times
- The Times
- Los Angeles Times
- The Observer
He even co-wrote an original graphic novel titled Get Jiro! For DC Comics/Vertigo.
Between 2002-2018 he hosted a number of shows, including:
- A Cook’s Tour
- No Reservations
- The Layover
- Parts Unknown
He worked on various other television shows, doing everything from judging to producing.
With the sudden news of Bourdain’s death, people from all across the world have paid homage to the man who did so much to try and share the beauty of diversity with us all. In the days following Bourdain’s death fans paid tribute to him outside his now-closed former place of employment, Brasserie Les Halles on New York City’s Park Avenue.
Fellow celebrity chefs and other public figures expressed sentiments of condolence, including Gordon Ramsay and Andrew Zimmern.
Beyond his amazing adventures of cooking in different countries, Bourdain also believed in making a difference for those less fortunate. He championed industrious immigrants from places like Mexico, Ecuador, and other countries in Central and South America.
He became a big advocate in the fight against sexual harassment in the restaurant industry in 2017, calling out other celebrity chefs and people in Hollywood.
Depression and Suicide
Anthony Bourdain had also been open about his struggles with depression. In 2016 he did an episode of Parts Unknown where he traveled to Argentina for psychotherapy. At one point he tells the camera,
“I will find myself in an airport, for instance, and I’ll order an airport hamburger. It’s an insignificant thing, it’s a small thing, it’s a hamburger, but it’s not a good one. Suddenly I look at the hamburger and I find myself in a spiral of depression that can last for days.”
While the passion he had for his work is quite obvious, traveling around 250 days of the year can take a toll. More than once he described his life as lonely. During an interview with People magazine, he said he was living the dream, but admitted that it did come at a cost. That cost may have had something to do with the ups and downs of marriage and divorce he experienced over the years.
Only a few months ago, when discussing his 11-year-old daughter Ariane, Bourdain had said he felt he had to “at least try to live” for her. Although he explained he also felt he did have things to live for. Sadly, it seems that over time, the iconic chef started losing his battle with the feelings he wrestled with on the road.
Anthony Bourdain’s death is another tragic loss in a trend we have seen a spike over the years, including among celebrities. Only three days before Bourdain’s own death, fashion designer Kate Spade took her own life. Suicide is a growing problem in the United States. According to a survey published by the US Centers for Disease Control and Prevention:
- Suicide rates increased by 25% across the country over nearly two decades ending in 2016.
- 25 states have experienced a rise in suicides by more than 30%
While Anthony Bourdain may have been clean for decades, there was still pain there. While overcoming drugs may have been a huge victory in his inspiring legacy, other fights can still wear us down.
There is Help
As we remember the incredible impact that Anthony Bourdain had as an adventurer and advocate, we emphasize the importance of supporting those who need it the most. Sadly, we don’t always know when people need help. But we should always work to make sure people know that there is help, no matter what they are struggling with.
“As you move through this life and this world you change things slightly, you leave marks behind, however small. And in return, life — and travel — leaves marks on you. Most of the time, those marks — on your body or on your heart — are beautiful. Often, though, they hurt.”
June 25, 1956 – June 8, 2018
Mental health is an important part of recovery for people who struggle with drugs or alcohol. Fighting depression and suicide prevention means supporting well-being and fighting for mental health support. For those struggling, treatment for mental health disorders and addiction is not always the easiest thing to seek out, but as we as a nation continue to evolve the conversation and raise awareness more people are finding out about the amazing pathways to a life in recovery that are out there. We urge you to seek yours. If you or someone you love is struggling with substance abuse, please call toll-free now. You are not alone.
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