An individual's alcoholism can adversely affect an entire family. Often an alcoholic's family suffers from emotional, physical, and psychological abandonment. Such is the case in the film, When a Man Loves a Woman, which realistically represents alcoholism and its effects on the family unit. Alice Green (the alcoholic protagonist), experiences the classic alcoholic's stages that include cause, effects (usually felt by the alcoholic's family), recognition, and rehabilitation. Alice accurately portrays several behaviors characteristic to the white female alcohol abuser. The film, however, does not fully reflect the alcoholic's profile (Dawkins & Harper, p. 347).

Typical of white female alcoholics, Alice consumes liquor alone in her home, as opposed to more social black female alcoholics (Dawkins & Harper, p. 347). Moreover, Alice's non-depressed personality characterizes alcoholics who have neither undergone repeated treatments nor experienced heightened marital problems. In contrast, her uncontrollable consumption confuses features typical of non-depressed alcohol abusers with those of depressed alcohol abusers (McMahon & Davidson, p.179).

When a Man Loves a Woman covers all four phases of alcoholism (cause, effects, recognition, rehabilitation), yet does not precisely explain the causes for Alice's alcohol addiction. Alice's father's previous alcohol problem increased the likelihood of her experimentation with the drug, as opposed to children raised in sober homes, yet she never cites this as a cause of her addiction (Windle, p. 181). However, with the exception of Michael's irregular schedule, the couple shows no signs of marital problems. Actually, first portrayed as helpless romantics the couple flirts in a local diner [click here to view this scene] and escapes to Mexico on a weekend getaway. According to Valgum and Valgum (1987), however, over half of women alcoholics attribute their dependency to difficulty with a significant other, yet Alice never attributed her alcoholism to problems with Michael, her husband (Valgum & Valgum, p. 501). Alice does credit her drinking to stress caused by her job, as well as the responsibility of often raising her family alone, due to her husband's frequent business trips (he works as an airline pilot). In fact, of the causes Alice identified, none matched the reasons compiled through Valgum and Valgum's (1987) research.

Despite the causes leading to this disease, children undoubtedly feel its negative effects. Parents often live in denial of their children's knowledge of their alcoholism, but studies show that children recognize the addiction, and even feel capable of stopping it (Christensen, 1997). Yet in the film, Jess and Kasey do not truly recognize their mother's alcohol consumption until after she is hospitalized and sent to rehabilitation. According to Christensen, on a day-to-day basis children of alcoholics fear abandonment, feel a lack of love and embarrassment. Yet Jess only feels deserted after Alice leaves, most obvious through her attempt to act out the role of mother by cooking breakfast for Kasey. Neither child shows signs of feeling humiliated or deprived of love and Kasey does not demonstrate feelings of desertion. This results from Alice and Michael's authoritarian parenting style, not typically seen in alcoholic families.

Furthermore, a parent's alcoholism may detrimentally affect a child's development. Considering children identify drinking problems at four to five years of age, the same period which their personality begins processing emotions of guilt, the lack of affection provided by alcoholic parents, versus nonalcoholic parents, may contribute to early feelings of responsibility for their parent's drinking problem (Christensen, p. 28). Kasey and Jess, however, never show signs of feeling responsible, perhaps because their parents usually shower them with affection.

Alcoholic parents also tend to nurture and attend less to their child's needs (Windle, p. 181). Alice exhibits the 'less nurturing and attentive' side when she returns home one afternoon obviously inebriated. Seeing Jess in the living room, Alice commands that she finish her homework, ignoring her daughter's request to admire a picture she draws on the computer. After making this demand, Alice stumbles upstairs to find some aspirin, walks into her closet, retrieves a liquor bottle, and washes down the medicine. All the while, Jess watches her mother's irresponsible actions, concerned that she is ill. The second time Jess questions her mother's health, Alice responds by smacking her daughter across the face [click here to view this scene]. Following this abusive act, Alice attempts to take a shower, but faints and falls to the floor, along with the glass shower door that shattered on impact. Jess runs in, only to see her mother lying among the debris and assumes she is dead. This physically abusive behavior Alice showed Jess proves typical of alcoholic parents and is increasingly common during intoxication (Famularo & Stone & Barnum & Wharton, p. 481).

Aside from damage done to parent-child relationships, the strain of alcohol abuse often profoundly affects marriages. Spouses of alcoholics exhibit recurring characteristics, such as domineering personalities, feelings of guilt, fear, anxiety, and anger (Rotunda & O'Farrell). Michael does not demonstrate the typical qualities of an alcoholic's spouse. Instead, he remains loving and supportive of his wife, and only shows emotions of fear and anxiety when Alice's convalescence began. This unfaltering support acts as a positive drive for Alice's recovery and accounts for the couple's lack of marital problems.

Despite this encouragement from Michael, Alice allows her family to witness scary episodes caused by her drunkenness before she recognizes her problem. For example, she falls out of a canoe and nearly drowns and thus acknowledges her problem. The following day, she promises Michael, and herself, that the excessive drinking will stop. According to the Denial Rating Scale Alice falls into Level 3 because she recognizes that alcohol contributes to her problems, but denies implications involving her family (Goldsmith & Green, p. 619). Yet her promise goes unfulfilled, made obvious by her continued abuse of alcohol. While hospitalized, after falling through the shower door, Alice confesses the extremity of her alcohol obsession to Michael. This moves her to Level 5 on the Denial Rating Scale because she now admits to uncontrollable alcohol binges, and agrees to seek professional help (Goldsmith & Green, p. 620).

Following her release from the hospital, Alice enters a rehabilitation center where she undergoes a detoxification period. During this time she experiences withdrawal symptoms including sweating, shaking, uncontrollable crying, and irritability. Congruent with the Windsor Clinic Alcohol Withdrawal Assessment Scale for uncomplicated withdrawals (1995), Alice's symptoms accurately portray a detoxification period for someone with an equally severe alcohol addiction (Metccalfe, Sobers, & Dewey, p. 368). When a Man Loves a Woman's realistic portrayal of this stage in overcoming alcoholism does not romanticize the issue, instead it mirrors empirical evidence.

When a Man Loves a Woman attempts to show the adverse effects of alcoholism on one's family and marriage, yet fails to accurately portray the traits characteristic of an alcoholic's children or spouse, as found through scientific research. Although Alice's alcoholism could have ruined her life, as well as her family's, through her recognition and willingness to work at sobriety, she salvages her livelihood. When a Man Loves a Woman last shows Alice at an Alcoholics Anonymous meeting celebrating her sixth month of sobriety. At this point in recovery Goldsmith and Green (1988) note an optimistic outlook on sober life and highly predict full recovery (Goldsmith & Green, p. 615). Although Alice has maintained an alcohol-free lifestyle, the problems induced by her addiction remain unsolved. She takes responsibility for these complications, though, and hopes to reconstruct what her addiction tore apart. Unfortunately, though, all alcoholics do not recognize their disease and therefore never recover successfully.

Christensen, E. (1997). Aspects of a preventive approach to support children of alcoholics. Child Abuse Review, 6, 24-34.

Christensen describes life growing up in a household with one or two alcoholic parents, from a child’s perspective. This research intended to examine the affects alcohol addicted parents have on their children’s problems and day-to-day life (based on the children’s opinion), and find ways to improve support efforts for the family of alcoholics. In face-to-face interviews, parents and their children were questioned, but usually separately. The parents tended to believe their children were unaware of their alcoholism, but the children often remembered their parent’s struggle with alcohol at age four or five, and believed that they could stop their parents from drinking. Those parents who did admit to having a drinking problem lessened the feeling of guilt their children experienced. On a day-to-day basis, children of alcoholics feared abandonment, felt a lack of love, and were embarrassed. These children said that days of soberness often meant more attention, but when the drinking persisted, crying and acting distant became common ways to cope. Even though many children confided in either a sober parent or sibling, Christensen identified a shortage of peers with whom these children could discuss such problems. Overall, these children thought that alcohol recovery should not only focus on the alcoholic, but on the families, as well (specifically the children).

Dawkins and Harper's study focuses on the similarities and differences between black and white female alcoholics. The difference in race signified distinctions in drinking habits. White female alcoholics blamed relationship difficulties with men as a cause for their addiction. White women also tended to drink liquor in their homes while alone, while black female alcoholics more often drank beer or wine in a more social setting. White women also experienced psychological problems more than black women did. Even following a match of demographic features, the difference in held relevance as a variable when assessing black and white female alcoholics.

Famularo et al note, firstly, that alcoholism has, in the past, been strongly associated with the mistreatment of children. Their study did not reveal a cause-and-effect relationship between alcohol and maltreatment of children. Instead they discover the close relationship between the two issues. This means that a person who drinks has a higher likelihood of mistreating their child, but the possibility exists that such a parent may never mistreat their child. Famularo et al also suggest possible ways in which to help this prevalent problem of abuse. They state the importance of one’s recognition of alcohol abuse as a large part of the physical abuse problem. Knowing this, the addition of child abuse prevention to alcohol abuse prevention programs may curve this trend.

Goldsmith and Green’s article establishes a systematic approach for assessing the denial levels in alcoholics. The Denial Rating Scale came about so clinicians could decipher patients' therapy needs. This scale includes eight different levels of denial with Level 1 meaning complete denial of having any sort of problem and Level 8 including the acknowledgement of their alcoholism, and reluctance to return to that lifestyle. Counselors at the Alcoholism Clinic tested DRS, by using the specific scale to evaluate patients and found reliable results. This study shows that those forced to enter the rehabilitation program experienced more denial than those who came voluntarily. Overall, though, this scale provided a uniformly systematic approach to assessing alcoholics' denial.

McMahon, R.C., & Davidson, R.S. (1986). An examination of depressed vs. non depressed alcoholics in inpatient treatment. Journal of Clinical Psychology, 42 (1), 177-183.

McMahon and Davidson present information linking alcoholism and depression among patients who enter rehab. Two hundred forty-three male patients were observed for four years and results are based on questionnaires and psychometric instruments. Studies found that those who consumed liquor six months prior to entrance were more depressed than those who consumed beer and wine. Members of the depressed group had also suffered from alcoholism for more years, undergone more treatment, encountered more marriage-related problems, and experienced greater uncontrollable consumption. The subjects also tended to have a poor self-image and impaired cognitive thinking. However, the two groups showed similarities in age, income, occupational functioning, and alcohol intake.

Metcalfe, Sobers, and Dewey devised a scale for assessing withdrawals experienced after alcohol detoxification. The Windsor Clinic Alcohol Withdrawal Assessment Scale includes the following symptoms: nausea and vomiting, tremor, anxiety, agitation, thought disturbances, auditory disturbances, convulsions, visual disturbances, quality of contact, and level of orientation. Significant variables in determining severity of withdrawals included drinking patterns. Patients who drank alone more commonly experienced severe withdrawals. Tested at the Windsor Clinic for six months among detoxification patients every hour, the WCAWAS proves valid.

Newsome and Ditzler explain the Denial Rating Scale used to assess alcoholics. The study, conducted to determine the reliability of the criteria set for the Denial Rating Scale, estimates that alcoholics’ denial of their problem and assesses change throughout treatment. The scale, which has eight steps, appears highly effective in determining the patients’ progress through therapy. Upon completion of the study, an improvement of denial had occurred: the denial rating had shifted at least two levels upward. Those who completed the program were at least twice as likely to have remained alcohol-free six and 12 months after release from the treatment. Based on these findings, Newsome & Ditzler conclude that the Denial Rating Scale proves reliable and valid when assessing the needs of alcoholics seeking treatment.

Rotunda & O'Farrell describe how expressed emotion (EE) correlates with a relapse in problem drinking. Through experimentation, they discovered a positive correlation between EE and alcohol relapse, yet these results are possibly due to uncontrollable outside factors. Prior to an evaluation in this field, establishment of an understanding of the alcoholic's relationship is necessary. Several recurring characteristics arose in spouses of alcoholics such as: domineering personalities, feelings of guilt, fear, anxiety, anger, and questioning their marriage. These factors effect not only the EE of the alcoholic's spouse, but also the EE of the alcoholic themselves. Between drunkenness and sobriety, the level of expression of EE shows a definite change. Researchers suggest that one's EE levels changes with the amount of alcohol consumed. For a deeper understanding of this, couples attended extensive therapy sessions. During these sessions, couples worked on establishing highly effective, working communication skills and establishing sobriety. This study found the therapy highly effective, noting that low levels of EE do not necessarily mean that a good, functioning relationship is present.

Valgum & Valgum conduct a series of interviews and tests in order to compile statistics concerning the effect marital relations have on alcohol abuse. They administer the SADS (20), a test diagnosis of psychotic personalities, and interview the sixty-four female alcoholics concerning their family background, drinking history, interpersonal relationships, etc. From these interviews Valgum & Valgum discovered thirty-three (51%) of the women accredit their drinking problem to their partner. Of those, twenty-one women stated that they began drinking in order to keep their current alcoholic partner with them. The Other twelve initially drank following divorce from their partner. The other thirty (46%) participants claim that they’re drinking was initiated by another force such as death in the family, to prevent psychotic breakdowns, or to keep from feeling socially outcaste. Valgum & Valgum conclude that partner problems act as a definite factor in initializing alcohol abuse, yet when the person already drinks abusively it seems that partner problems have no influence on the level of drinking.

Windle educates the public of the effects on children and marriages. He notes that children of alcoholic parents have an increased likelihood of drinking and experimenting with drugs. Windle also mentions that alcoholic parents are generally less nurturing and attentive to their children, than those who do not drink. Windle describes how an alcoholic parent serves as a poor role model for their children. For example, in a double-blind test in which preschool children were asked to identify alcohol by smell, children of alcoholic parents more easily identified alcoholic beverages more easily than those whose parents refrain from drinking. These people usually exhibit higher levels of marital conflict than those who do not abuse alcohol. These higher levels of marital discontentment may also add to a higher incidence of child or spousal abuse.