I did a lot of movie and TV series watching over the summer. The goal had been to spend as much time with my dad and my dad was mostly at home. I tapped into a goldmine of recent releases and entire seasons of TV shows that I wanted to watch at the local library. I was practically there every day.
I borrowed the film Flight one day and watched it with my dad. It was an entertaining film. I'm not really a fan of Denzel, I don't find him overly fascinating but he always does a convincing job. Perhaps acting out of control like the character, was a stretch for his work and that's what fascinated people so much about the film. In the end, I don't care to recommend it or not. I just saw it and that's that.
Yet, there was something that bothered me and really it's not so much to do with the film but the general depiction of alcoholics in general. I read some reviews of the film and most people that considered the film unrealistic were referring to the plane crash. I saw the most unrealistic part to be the alcoholism. And I don't say that in the sense that an excessive use of alcohol doesn't happen and no one drinks that way, I just mean that, it wouldn't have been an interesting film if it didn't show what in most cases alcoholism looks like.
About a week after I saw this film I watched the film The Master with Joaquin Phoenix, who was also an alcoholic. Again, he was a worst case scenario as he was drinking jet fuel and paint thinner. My question, is does the extreme depiction of alcoholics make us blind to what alcoholism looks like in everyday life?
I looked up Alcohol Abuse on the internet and this is what I found: Excessive use of alcohol and alcoholic drinks. How vague. Thanks for nothing. On the website for the National Institute on Alcohol Abuse and Alcoholism (NIAAA) things got a little more specific:
Moderate or 'low-risk' drinking:
For men:
No more than 4 drinks on any single day AND no more than 14 drinks per week
For women:
No more than 3 drinks on any single day AND no more than 7 drinks per week
Even within these limits, you can have problems if you drink too quickly or have other health issues.
I still felt that this was not enough. In my research I was starting to wonder if all doctors and specialists definitions to alcoholism made it so they might not consider otherwise. It reminded me of how doctors and naturopaths diagnose thyroid problems differently. Doctors use a much smaller spectrum on a higher scale of symptom before they consider a patient to having a thyroid problem whereas naturopaths use a broader spectrum, starting much lower in the dysfunction of the thyroid, diagnosing thyroid problems much earlier. Are we therefore too late in our definition of alcoholics? Does our medical system set us up to be too far gone before we treat the problem?
I eventually came across this article on Wikipedia on the High Functioning Alcoholic. A High-Functioning Alcoholic is a form of alcoholism where the alcoholic is able to maintain their outside life such as jobs, academics, relationships, etc. all while drinking alcoholically.
Here is the list of signs and symptoms:
This list is intended to be used as a guide and not as strict diagnostic criteria.[1]
1. Drinking patterns
- When they have one drink, they experience a craving to have more and cannot predict what their alcohol intake will be
- They obsess about the next time they will be able to drink alcohol
- They behave in ways that are not characteristic of themselves while drunk and continue to repeat these behaviors and patterns
- Surround themselves socially with heavy drinkers
- Getting drunk before arriving at social engagements
- Setting drinking limits (e.g., only having three drinks, only drinking three days per week) and not being able to adhere to them
- Driving drunk and not getting arrested or involved in an accident
- Always having to finish an alcoholic beverage or even another person's unfinished beverage
- Using alcohol as a reward
- Having memory lapse due to excessive drinking (blackouts)
- Taking breaks from drinking and then increasing alcohol consumption when they resume drinking after a long period of time
- Not being able to imagine their life without alcohol in it
2. Denial
- Have difficulty viewing themselves as alcoholics because they do not fit the stereotypical image and because they feel their lives are manageable
- Avoid recovery help
3. Professional and personal life
- Well respected for job/academic performance and accomplishments
- Can maintain a social life and intimate relationships
4. Double life
- Appear to the outside world to be managing life well
- Skilled at living a compartmentalized life (i.e., separating professional, personal and drinking lives)
5. Hitting bottom
- Experience few tangible losses and consequences from their drinking
- May hit a bottom and not recognize it clearly
I found this list of signs and symptoms much more informative. (Further characteristics and risks can be seen in this article called, Not Just A Drunk - The Signs and Risks of High Functioning Alcoholics.) Can you imagine the person that drinks everyday for 30 years, experiences few tangible losses and never hits rock bottom and never looks like a stereotypical alcoholic. Essentially, isn't actually drunk. As I see it, that person will end up with the health repercussions of alcoholics - twice the risk of cancer, twice the risk of heart disease, twelve times more likely to die of cirrhosis of the liver, three times more likely to die in a road traffic accident or six times more likely to commit suicide.
In fact, when I began my research into High Functioning Alcoholics, I found some eye-opening statistics: In a landmark study in 2007 by the National Institute on Alcohol Abuse and Alcoholism, the researchers categorized alcoholics into 5 subtypes: 20% are the "functional" subtype, 32% are the "young adult" subtype, 21% are the "young antisocial" subtype, 19% are intermediate familial subtype (middle-aged with mental illness), and only 9% are of the "chronic severe" subtype, fitting the stereotype of the low-bottom alcoholic. Other additiction experts estimate that between 75% and 90% of alcoholics are high-functioning. (Psychology Today, January 21, 2009)
And how many alcoholics are actually reported? Well, mainly the ones that are drunk all the time and fit the stereotype I assume. In Canada, that is 4% of the population or 1.4 million Canadians. In the US it is 18 million Americans or about 6% of the population.
And what about the personal relationships? Are they ever really completely connected to those around them? Or is there really just a giant of bottle of something between the alcoholic and their loved ones? I would assume the latter.
I guess my biggest interest is this: does the high functioning alcoholic (the one that has a drink or two or more, everyday for 30 years) have the same affect on their children as does the stereotypical alcoholic (like the one in the film Flight)?
From what I have read, it is not different. There is always a large elephant in the room when it comes to alcohol abuse or just consistent, continuous drinking. I found this wonderful article entitled, The High Functioning Alcoholic at Psychology Today and it explains in great detail the life affected by an HFA. For loved ones it is extremely confusing and there is often an emotional disconnect with the HFA regardless of how well they function. In fact, as predicted, it's probably harder to intervene with an HFA because it can really seem like there isn't a problem since they don't fit the stereotype and might just fall past the definition of alcoholic based on number of drinks per day or week. A good predictor if you have been raised by an HFA is the characteristics of adult children of alcoholics:
Adult children of alcoholics:
:: guess at what normal is
:: have difficulty in following a project through from beginning to end.
:: lie when it would be just as easy to tell the truth.
:: judge themselves without mercy.
:: have difficulty having fun.
:: take themselves very seriously.
:: have difficulty with intimate relationships.
:: overreact to changes over which they have no control.
:: constantly seek approval and affirmation.
:: feel that they are different from other people.
:: are either super responsible or super irresponsible.
:: are extremely loyal, even in the face of evidence that loyalty is undeserved.
:: tend to lock themselves into a course of action without giving serious consideration to alternative behaviors or possible consequences. This impulsivity leads to confusion, self loathing, and loss of control of their environment. As a result, they spend tremendous amounts of time cleaning up the mess.
I don't think it uncommon at all to know people that might display a few of these characteristics. I assume that an adult child of an alcoholic might never understand why they just don't fit in or feel normal and go through their whole life not understanding that it was the HFA in their lives and not them that warped them into the person that they are. In fact, seventy six Americans, about 43% of the US adult population, have been exposed to alcoholism in the family. Almost one in five adult adult Americans (18%) lived with an alcoholic while growing up (consider that these statistics are reflecting stereotypical and more obvious alcoholics). There are an estimated 26.8 million children of alcoholics in the US. Preliminary research suggests that over 11 million are under the age of 18.
When I think back to my original inspiration for this article I realize in some ways that Denzel's character was in fact a High Functioning Alcoholic. I found this article written about the HFA and the film Flight:
I was struck by the power that the term “drunk” had in this movie. Whip had created an identity and façade of success and honor by way of his career. Therefore, when a wealthy owner/investor of the plane held a meeting following the crash and referred to Whip as a “drunk”, it echoed in my mind. That term is so often used with lower functioning alcoholics and it was refreshing that this character leveled the playing field for Whip and others like him. Additionally, Whip’s son, in an enraged tone, called him a “drunk” and the audience began to see how Whip’s alcoholism had negatively impacted his family for many years—they were not blinded by his success and were able to see Whip’s alcoholism clearly.
I guess that might be where I and the author of this article disagree. Everyone seems to know that he is a drunk. His wife and son aren't with him anymore because of that reason. Yes, I agree he is High Functioning, he flies planes with high levels of alcohol in his system but it seems more to me that everyone is just covering up for him, hoping that he will stop then wondering if he really has a problem. I guess that just adds another layer to what the definition should be for an HFA or an alcoholic. Or maybe what this movie really represents is how truly difficult it is to intervene with an alcoholic of any type and how important hitting bottom is in the recovery of an alcoholic. Look at all the things that happened to Denzel before he actually hit bottom and those are the events that took place in just a short time. Bottom was not years before when his wife and son left him. If we are looking at the bigger picture for the film Flight, the best treatment is to treat those affected by the alcoholic. Nicole left, the family left. Enabling is probably the alcoholics worst enemy. The lawyer and the Union rep enabled. If those around are treated for the alcoholics disease, there become boundaries and a new language for interacting with the alcoholic which can hopefully contribute to a bottom as opposed to enabling.
In the end, I think the average High Functioning Alcoholic would have made a boring movie. But at least this one got some of us talking.
For more information on the above topic please check out the website High Functioning Alcoholic and/or Al-Anon or Alateen. I hope that this helps someone.
XO,
Suzanne