Resilience in Adult Children of Alcoholics: A Nonpathological Approach to Social Work Practice

Imperative for social work practice is the need to examine practice frameworks that may inadvertently label variations in cultural expression, ways of navigating stress or social oppression and threats of harm, or periods of reassembly in negative or pathological terms. Such variations in coping strategies may in fact be indicative of creative responses and strengths in the face of personal or familial stress and institutional or social oppression. This article discusses research that used a qualitative approach to explore an alternative view of adult children of alcoholics (ACOAs). This population was selected because of the epistemology of pathology that grounds research and practice in the area of substance abuse in general and alcoholism in particular. The author developed the Differential Resiliency Model (DRM) as a means of obtaining a nonpathological approach to understanding the resilience of ACOAs. CURRENT EPISTEMOLOGY: ALCOHOLISM AS A DISEASE The belief that alcoholism is a disease is deeply entrenched in both research and popular literature (Ackerman, 1987; Beattie, 1987; Bennett, Wolin, Reiss, & Teitelbaum, 1987; Black, 1981; Freeman, 1992; Goodwin, Schulsinger, Knop, Mednick, & Guze, 1977; Moos & Moos, 1984; Parker & Harford, 1988). "The disease model provided 'threshold' information about addictions when not much was known about the subject from research and practice experience" (Freeman, 1992, p. 4). Yet attempts to understand the specific nature and transmission of this "disease" have resulted in findings that indicate "there is no reliable empirical evidence to support the physiological pathological process" (George & Marlatt, 1983, p. 107). Other researchers agree (Clair & Genest, 1987; El-Guebaly & Offord, 1977; Jacob & Leonard, 1986; Jacobson, 1983; Murray, Clifford, & Gurling, 1983; Schuckit & Sweeney, 1987; Searles, 1988; Sundgren, Yates, Peterson, Piazza, & Yeager, 1986). Despite these findings, the disease model prevails as the current framework used by both the professional community and the lay public for understanding alcoholism. Books written about ACOAs reiterate the belief that the experience and effect of alcoholism are pathological (Beattie, 1987; Black, 1981; Kritsberg, 1986; Wegscheider-Cruse, 1985). Wegscheider (1981) summed it up, stating, "Everyone whose life touches the alcoholic's is in one way or another affected by his disease; its direct consequences fall on members of his immediate family, those who in a most literal sense share his life and eventually his illness" (p. 76). The result is to view adults who grew up in homes where alcoholism was present in pathological terms (Ackerman, 1987; Anderson, 1994; Beattie, 1987; Black, 1981). Cermak (1986) proposed a new diagnostic category of "codependency" in the DSM and viewed this condition as a "personality disorder" (p. 24). DIFFERENTIAL RESILIENCY MODEL: ONE ALTERNATIVE VIEW The concept of resilience, sometimes referred to as "invulnerability," is relatively new."In an attempt to understand, anticipate, and treat the pathological, the survivors and thrivers appear to pass almost unnoticed amidst the holocaust of disadvantage and tragedies of those who succumb to it" (Anthony & Cohler, 1987, p. ix). Other researchers concur (Anthony, 1987; Antonovsky, 1985; Cowen & Work, 1988; Flach, 1988). Felsman and Vaillant (1987) pointed out that "clinical language rarely includes the process of healthy adaptation" (p. 302). Emerging is a lively dialogue regarding resilience and the strengths perspective (Saleebey, 1996). However, there does not appear to be any systematic study of resilience in ACOAs. The lack of a corresponding language to capture such characteristics influenced the author to create a new model for understanding the life experiences and functioning of ACOAs. In naming the DRM, the term "differential" was used to convey the idea of varying qualities and attributes that can be generally distinguished from each other and to present the concept that there is a range of related characteristics measurable in increments or degrees. …