ALCOHOLISM TREATMENT ISSUES IN WOMEN: MOTHERING AND SEXUALITY
Mothering and female sexuality are two aspects of self-esteem unique to women. If the woman alcoholic has children, some of the questions she may well be asking herself are the following: “Am I a good mother?” “Can I be a good mother?” “Have I hurt my children?” “Can I ever cope with my children if I don’t drink?” These may not be explicit in the alcohol counseling, but they do cross her mind. They begin to be answered, hopefully positively, as she gains sober time. Family meetings may also be one way she gains answers to these questions. However, in some cases where there has been child abuse or a child is having special difficulties, a referral to a children’s agency, a family-service agency, or a mental health clinic may be important in dealing with these situations. One of the things any alcoholic mother will need to learn to regain her self-esteem as a mother is a sense of what the “normal” difficulties are in raising children.
In terms of her sexuality, there may be a number of potential questions. If there has been a divorce or an affair, she may well be wondering about her worth and attractiveness as a woman. Even if the marriage is intact, there may be sexual problems. On one hand, the sexual relationship may have almost disappeared as the drinking progressed. On the other, it may have been years since she has had sexual intercourse without benefit of a glass of wine or a couple of beers to put her “in the mood.” Again, sober time may well be the major therapeutic element. But couples’ therapy and/or sexual counseling may be needed if marital problems are not resolved. In cases where the sexual problems preceded the active drinking, professional help is certainly recommended. Sobering up is not likely to take away the existing problem in some miraculous fashion, To let it fester is to invite even more problems.
What about single women, or women caught in an unsatisfactory marriage? It is not uncommon for them to find themselves “suddenly” involved in an affair or an extramarital relationship. With a little bit of sobriety, they are very ripe to fall in love. This may have several roots. The woman may be questioning her femininity, and the attentions of a man may well provide some affirmation of her status as a woman. Also possible is that with sobriety comes a sense of being alive again. There is the reawakening of a host of feelings that have long been dormant, including sexual feelings. In this sense, it may be like the bloom and intensity of adolescence. A romantic involvement may follow very naturally. Unfortunately, it can lead to disaster, if followed with abandon. It should be noted that this can be equally true for men!
We would caution male counselors working with women that if you are the first person in many years to accept her, and if you have been making attempts to raise her self-esteem, she may mistake her gratitude for a personal emotional involvement with you. Your recognition of this “error” is imperative. If you provide contacts for her with other recovering women alcoholics, she may be better able to recognize this pitfall as well.
Another area of great concern when treating women is children. If an alcoholic woman has young children, long-term residential treatment may be very difficult to arrange. Many have no husbands in the home, and extended family members do not live down the street as was once the case. However, for that very reason, it may be all the more important. Models of treatment to overcome this problem are being tried in many areas throughout the country. But in most places the usual facilities are still the only ones available. You will need to stretch your creativity to the limit to deal with this problem. Potentially, friends, extended family—even if they are called in from a distance—or a live-in sitter can be used. There may be no way to allow her the optimum advantage of a 2- to 3-week stay in residential treatment. If this is the case, daily outpatient visits, intensive AA contact, or day treatment are possible options. Even if inpatient care can be arranged, you will be faced with her intense guilt over her children and her resistance to leaving them. There are no easy formulas, and the counselor is left to work out the best solution possible in each individual case.
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