Alcoholism and the Family Video Transcript

Webcast Transcript

RICHARD ROSENTHAL, MD: I think that if somebody is not accepting that they have a problem, then checking up on them is really not gonna be all that helpful. Alcoholics are usually much smarter about being alcoholic than the family members are. They're gonna be able to surreptitious. They're gonna hide the bottlesin places that you won't think of. That's the nature of the disease. They've got an axe to grind. They've got to do that. They're highly motivated to make sure they've got their pipeline to the bottle. So checking is sometimes an exercise in futility and a recipe for frustration.

I think that having, again, a more reasonable talk with somebody about their drinking behavior and trying to get them in a nonharsh, nonpunitive way is probably the best route.

CAROL WEISS, MD: I agree with you completely, but on the other hand, there are times when threats and what we call sometimes "leverage" is helpful. Sometimes all the nice discussions and gentle coercion doesn't work. As Rick alluded to, there are times when it does work. There are times when if you do threaten, if you have to get to that point, where you threaten someone with the end of a relationship or with the loss of the job. It can help motivate them a little bit further.

And moreover, I do want to say one thing about the hitting bottom. Being in treatment against your will is not necessarily bad or wrong. It's not optimal, but there are plenty of people who get sent to treatment by loved ones, the courts, etc., who do get something out of it and do begin the road to recovery. So that's worth throwing in there too.

RICHARD ROSENTHAL, MD: And I'll throw in a piece about what they call contingency management, which is what Carol was talking about. There definitely is a use for it. But again, it's somebody who should be in treatment, so it's a carefully planned set of contingencies about what the negative consequences are for drinking behavior. When it's done properly, it can be very very useful.

DAVID MARKS, MD: The bottom line is that families should be involved in the treatment of alcoholics, but they should talk to a professional before they take any actions, correct?

RICHARD ROSENTHAL, MD: I agree with that.

CAROL WEISS, MD: That's right.

DAVID MARKS, MD: Okay. Carol Weiss, Rick Rosenthal, thanks for helping us out. And thank you for joining us. I'm Dr. David Marks. Goodbye.

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