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Doctor Blake
Doctor Blake, Psychologist
Category: Mental Health
Satisfied Customers: 146
Experience:  Ph.D., Ed.S., NCSP Clinical Psychologist; 15+ years of experience; dual licensure
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How do I effectively communicate to my sister that she has a

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How do I effectively communicate to my sister that she has a drinking problem? She is a Nurse Practitioner and just recently has been counseled by management for compliants they have received by her co-workers about smelling alcohol and her constantly sucking on mints. She is currently out of work with an MD note. This is a wake up call for her and she still does not think she has a problem. Who in the Manchester area treats this? How do I get her to agree to talk to someone professional about her problem? If this behavior continues I am almost certain she will be terminated from her job, lose her license to practice. Currently her excuse is that her husband has a slow growing brain tumor but he is functional and currently working a full-time job, her son is MR but high function, and my 80 year old mother currently lives full-time with her. Those are the stressors she uses to drink. Also my mother drinks. When both are drinking they both fight & verbal abusive.

I'm sorry to hear about your son.

First of all, it would be impossible (and inappropriate) to diagnose your sister with having alcoholism over the internet. That can only be done by a licensed mental health professional after having seen and worked with him and completing some assessments. Within the parlance of the program of AA, however, "only you can know if you're an alcoholic."

With regard to your feelings regarding her behavior - your concern (and anger and frustration and confusion) is very common among those who choose to live with or around the alcoholic. A great place to begin to address your concerns is Alanon.

But before we move into that, a bit about alcoholism:

With regard to medical treatment for alcoholism, most general physicians don't have sufficient training to address the problem medically. Even general Psychiatrists (medical) and Psychologists (non-medical) are often woefully undertrained in chemical dependency. You/she may wish to consider consulting with a Psychiatrist who has training or is identified as an Addictions specialist. Some medications currently in use for alcoholism or alcohol abuse include:

- Naltrexone (to reduce alcohol's positive effects);

- Antabuse (to reduce cravings for alcohol and to produce adverse effects if drinking occurs);

- Campral (to reduce cravings for alcohol if you've already stopped).

Even addictions specialists will tell you that, to be frank, a good alcoholic will always find away to "work around" medications and will resume drinking.

With regard to treatment for alcoholism, scientific, peer-reviewed research indicates that the most frequent solution for alcoholism is "spontaneous recovery" - meaning that the individual stops or reduces consumption himself, without intervention... never to return to alcohol abuse or alcoholism. (Some question if these individuals are truly alcoholic.)

Despite the scientific literature, most experts will agree that AA is the best choice for treating alcoholism. Traditional psychotherapy has not been found to be particularly effective, nor has cognitive behavioral therapy or behavioral therapy to teach problem drinkers how to "control their drinking" (e.g., Sobel & Sobel).

As you probably know, AA is largely a spiritual program - and many individuals initially find the "God concept" difficult to grapple with. You've probably also heard that you can define God as you understand him. This isn't easy for most alcoholics.

I would encourage your sister to start attending AA meetings. She should watch for the people she sees there... and look for the similarities, not the differences. She may find herself wondering about someone there who seems to say things that make sense. This person may be older or younger, an alcoholic or an addict, but she looks happy and talks about recovery. It's your sister's job to approach this person and ask her to be her sponsor. AA works, but it is a "we" program, not an "I" program. If she's willing to accept the hands that are being offered to her, she may well find herself on a journey that will not only help with her alcohol problem, but may help with her sober problems as well.

Finally, if she can do nothing else, remember the big four (taken from the story "JOIN THE TRIBE" in the 3rd edition of the Big Book):

- Don't pick up;

- Go to meetings;

- Get a BIG BOOK and read it;

- Find a sponsor and talk to him.

These are considered the keys (along with the 12 steps) of recovery within AA.

In case you haven't checked, there are AA meetings around the clock all over the world. Check out: to find one near you. You mentioned that you were in Manchester... but I wasn't certain where that was located. I'm assuming somewhere in New England (CT?)... If you check the meeting finder, it will direct you to local chapters in your area. If you just go to a local AA clubhouse, they will have a "Where and When" with a directory of local meetings for every day of the week...

The AA website would also have literature such as "The Big Book" ( ) and Alanon literature for those in relationships with alcoholics.

Alanon is the sister organization of AA - and is for all the folks who must contend with having an alcoholic partner, spouse, child, parent, sibling (etc.) They can be reached at - and you'll also see postings for local meetings. I strongly recommend Alanon for you - as it will help you to cope with your feelings about this "alcoholic tornado" in your life... and help you come to some rational, manageable decisions about how to proceed. It may also help your daughter-in-law and her new family.

Some excellent reads to consider include:

Discovering Choices (Alanon.

(This is a brand new publication from the Alanon Family Group Headquarters. They offer many books, and smaller literature (articles, pamphlets) that you might find helpful.)

Why Don't They Just Quit (Herzanek, Hicks, & Lawrence). I've heard many clients and family members refer to this book as helpful.

Courage to Change (Alanon again).

Another Chance: Hope & Health for the Alcoholic Family (Wegsheider-Cruse).


BOT***** *****NE: Your sister may not feel she has a drinking problem until there is blinding evidence of it. You suggest that she is beginning to face some of the consequences of her drinking now... perhaps this is beginning to "chink away" at her armor... but she may require more consequences before she recognizes the truth. Every alcoholic must decide upon their own "bottom" and it's up to each individual to decide when s/he will stop digging. Perhaps your sister isn't ready to put down the shovel just yet. I know that this is hard for you - and that's why Alanon might be helpful for you. THERE IS NOTHING YOU CAN DO THAT WILL MAKE YOUR SISTER STOP DRINKING. She will need to learn this on her own... and you will need to learn to be supportive without enabling her behavior.


I *do* wish you both the best of luck in your struggles. Alcoholism is "cunning, baffling, and powerful." I hope you (and certainly your sister) find the patience, strength, humility, courage, and discipline to do address these concerns. You BOTH deserve it!

* FEEDBACK ENCOURAGED. Please contact me prior to leaving negative feedback so that we can resolve the matter. I am eager to work with all JA clients to provide them with useful/helpful answers. Thanks again.

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