The Party ’ s Over : Treating Grief During Recovery for Alcoholic Women

Society often expects alcoholic women in recovery to quickly move on with their lives. This can be a daunting task since many women experience grief and loss as a consequence of previous addictive behaviors or change in lifestyle. This grief and loss must be treated if alcoholic women are to abstain, long-term, from alcohol use and lead satisfying lives. This article distinguishes between symptoms of depression and addiction-related grief and concludes by detailing a specific model counselors can use to help female alcoholics in the recovery process. A hallmark of the addictions process is loss (Haberstroh, 2007). As a result, treating the addiction-related grief and loss experienced by clients with substance abuse or addiction issues is essential (Haberstroh, 2007). Giving the female alcoholic client an opportunity to genuinely express emotions regarding losses that have occurred as a result of alcoholism increases the likelihood that sobriety is maintained and recovery occurs (Shallcross, 2011). The addicted client cannot properly address the grief she is feeling and may deny the grief by drinking more heavily. When the client finally seeks professional help for her addiction issues, she may lack the healthy coping skills needed to acknowledge, address, and accept the losses that have occurred (Haberstroh, 2007). The deeply personal losses the client is facing come into sharp focus, and a need to deaden the intense pain may occur resulting in relapse, blocked healing, and may even place the client in continued danger (Boss, 2006; Haberstroh, 2007; Shallcross, 2011) . This article intends to assist counselors by defining addiction-related grief and loss and offering a unique treatment model that can be applied when working with female Ideas and Research You Can Use: VISTAS 2014 2 alcoholics. Definitions and examples of addiction-related grief, program theory and rationale, and specific implementation strategies will be discussed. Definitions and Explanation of Addiction-Related Grief and Loss The Impact of and Types of Loss Experienced Because loss is significantly interwoven with the addiction process, the losses that have occurred might have taken place prior to the onset of addiction, during active addiction, or during recovery (Shallcross, 2011). Losses might include marriages, jobs, income, or children, as well as loss of identity, concept of self, meaning in life, and potential for success. There are gender differences reported in the literature in terms of addiction-related loss. In a study investigating shame in alcoholic women, it was found that women lose much of their self-esteem and positive self-image due to the stigma of their alcoholism (DiBacco, 2010). Case example. The following case illustrates issues licensed professional counselors face when diagnosing and assisting clients presenting with addiction-related grief. A client calls and gives an intake at a counseling agency, reporting symptoms of sadness, sluggishness, sleep issues, loss of appetite, and constant stress and worry. The client reports that she knows it is not because of alcohol or drugs because she has been sober for more than 6 months. The client states that she does not understand what is wrong. She explains that she is depressed and has little interest in things that used to bring pleasure. This type of information gathered as part of an intake assessment is common among licensed professional counselors. The initial reaction of the counselor may be to diagnose the client using The Diagnostic and Statistical Manual of Mental Disorders (5 th ed.; DSM-5; American Psychiatric Association [APA], 2013). As part of this diagnosis, the counselor may compare symptoms of major depressive disorder (MDD) or dysthymia, bereavement, and substance use disorders. This comparison yields many similarities and overlaps (See Figure 1). For example, MDD/dysthymia often follows a severe psychosocial stressor such as the death of a loved one; bereavement is the reaction to the death of a loved one; and substance use disorders are accompanied by symptoms of depression, prolonged sadness, and grief (APA, 2013). Likewise, substance dependence (particularly alcohol or cocaine) may contribute to the onset or exacerbation of MDD; grieving individuals often present with similar symptoms as MDD, and mood disorders such as MDD or dysthymia are often present (APA, 2013). All three disorders include symptoms of marked functional impairment, sleep disruption or prolonged sleep, persistent sadness, decrease in perceived self-worth and lowered self-esteem, feelings of guilt, social withdrawal, preoccupation with the past, and anger (APA, 2013). How then, might a counselor properly diagnose and treat a client such as the case example given above? If the client has a history of substance abuse or addiction(s), and presents with the symptoms listed above, counselors may wish to consider treating addiction-related grief as part of the counseling process. To aid counselors with this process, a description of a specific model designed to treat the aforementioned symptoms of addiction-related grief and loss follows. Ideas and Research You Can Use: VISTAS 2014 3 Major Depressive Disorder / Dysthymia Bereavement Substance Use Disorders Often follows a severe psychosocial stressor such as the death of a loved one. The reaction to the death of a loved one. Symptoms of depression, prolonged sadness, and grief