Alcohol Use Disorders | Secondhand Drinking | ACEs – Trace Your Family ACEs Tree

Alcohol use disorders | Secondhand Drinking | ACEs — often, it’s a cycle. The behaviors of a person with an alcohol use disorder (AUD) cause secondhand drinking (SHD), and both AUD and SHD can change an entire family system. A changed family system can cause adverse childhood experiences (ACEs) for the current generation of children. And a child with ACEs can grow up to develop an alcohol use disorder and/or enter relationships or marriages with a person who has one.

Tracing your Family ACEs Tree can help break the cycle of family alcohol misuse. Doing this made all the difference for my mom, myself and my two daughters, and caused my mom to say to me during one of our phone calls, “Lisa – please – please use my story – our story – to help others.” And so I am.

But first…

About on the Terms Alcohol Use Disorders | Secondhand Drinking | ACEs

Alcohol Use Disorders (AUD)

AUD are caused by drinking patterns that change a person’s brain, thereby changing a person’s thoughts, feelings, and behaviors. These changed thoughts, feelings and behaviors are called drinking behaviors.

These brain changes are caused by the ethyl alcohol chemicals in alcoholic beverages changing the way brain cells “talk” to one another. This “talking” is how the brain controls everything a person thinks, feels, says, and does from driving, to walking, to talking, to how a person remembers things or reacts to another person’s thoughts, feelings and behaviors. When a person misuses alcohol over time it can chemically and structurally change their brain, making it more vulnerable to the key risk factors for developing a severe AUD. These risk factors include childhood trauma (aka adverse childhood experiences, ACEs), early use, genetics, mental illness and social environment.

Alcohol use disorders can be mild, as in binge drinking, or moderate, as in regularly binge drinking or engaging in heavy social drinking, or severe, as in developing a dependence on alcohol (aka alcoholism).

Secondhand Drinking (SHD)

SHD refers to the negative impacts of a person’s drinking behaviors on others. Drinking behaviors include: verbal, physical, emotional abuse; neglect; blackouts; unplanned/unwanted sex, sexual assault; breaking promises to stop or cut down; shaming, blaming, denying; unpredictable behaviors; and driving while impaired to name a few.

Drinking behaviors are typically unintentional (unless they are the behaviors a person exhibits when not drinking). They are the result of the ethyl alcohol chemicals in alcoholic beverages interrupting the brain’s normal cell-to-cell communication system while “waiting” to be metabolized by enzymes in the liver (at an average rate of 1 hour for each “standard drink,” which is defined as 5 ounces of table wine or 12 ounces of regular beer or 1.5 ounces of 80-proof hard liquor).

Drinking patterns that cause drinking behaviors include binge drinking, heavy social drinking and alcohol dependence (aka alcoholism). People engaging in these drinking patterns are referred to as alcohol misusers or a person with an alcohol use disorder (other familiar terms include alcohol abuser and alcoholic).

The negative impacts a person coping with SHD experiences are related to toxic stress. Toxic stress changes brain and body health and function, which can cause a person to experience migraines, anxiety, depression, stomach ailments, sleep disorders, autoimmune disorders, changes in eating habits, and so much more. Toxic stress also causes a person to adopt unhealthy, toxic stress-related, reactionary coping skills (explosive anger, physically lashing out, shutting down emotionally, as examples).

Note: these concepts similarly apply to other drug (cocaine, opioid, marijuana, meth, heroin, etc.) misuse and thus other drug misuse behaviors, causing impacts to others referred to as Secondhand Drugging (SHD).

Adverse Childhood Experiences (ACEs)

ACEs refers to traumatic incidents in childhood and were identified in the epidemiological CDC-Kaiser Adverse Childhood Experiences Study (ACE Study). This study of 17,000 participants looked at how 10 types of childhood trauma (ACEs) affect long-term health. These include: physical, emotional and sexual abuse; physical and emotional neglect; living with a family member who’s addicted to alcohol or other substances, or who’s depressed or has other mental illnesses; experiencing parental divorce or separation; having a family member who’s incarcerated; and witnessing a mother being abused.

The impacts of these ACEs are related to toxic stress, which is the repeated activation of the brain’s fight-or-flight stress response system.

A child experiencing SHD as the result of a parent’s AUD can result in adverse childhood experiences for that child.

Tracing Your Family ACEs Tree | Breaking the Cycles of Familial Alcohol Misuse

To help break the familial cycle of alcohol misuse, I am sharing the post I originally wrote for ACEs Connection, published on April 5, 2018, titled: Tracing One’s Family ACEs Tree to Break the Cycles of Familial Alcohol Misuse.” It goes into more detail on the concepts I explained above.

Alcohol Use Disorders | Secondhand Drinking | ACEs - Tracing One's Family ACEs Tree can help break the familial cycles of alcohol misuse

Tracing one’s family ACEs tree to identify Alcohol Misuse | Secondhand Drinking | ACEs can help break the cycle of family alcohol misuse.

My marrying an alcoholic never made sense to me. My mother developing the disease of alcoholism never made sense to me, either. And why my loved ones couldn’t get it together to stop or wrest control of their drinking was equally confusing. Yet I churned around and in and through this muck for almost four decades before my world was split wide open.

It was 2003 and one of my loved ones entered a residential treatment program for alcoholism. I remember experiencing a giddy – “I knew it, I knew it! I‘m not crazy” – kind of feeling. Finally! I thought. Finally I would be proven right – his drinking really was a problem. Finally someone else would take over trying to get him to stop. Finally this loved one would get fixed, all would be well, and life could return to normal.

But nowhere in that finally was I thinking, “Finally – I’m going to start my own recovery – recovery from SHD (SecondHand Drinking – the negative impacts of a person’s drinking behaviors on others) and ACEs (Adverse Childhood Experiences).”

But as I would come to accept, he wasn’t my only loved one with a drinking problem. As I would also come to accept, I’d spent decades rationalizing the drinking habits of a number of my loved ones, admitting their drinking was excessive and the cause of a host of problems in our lives, but certainly not alcoholic. That’s because I thought a person’s drinking had to be either “normal” or “alcoholic.” Since I was not about to label my loved ones as alcoholics, I tried to make their drinking normal.

Why? Like many of us, I believed that being an alcoholic was “bad.” It was a sign of “weakness,” “a lack of willpower” and perhaps most of all, a sign they did not love me enough to stop. Not only that, I didn’t understand that binge drinking, heavy social drinking, alcohol abuse, and alcoholism were all part of what is now referred to as an alcohol use disorder. I didn’t know that all of these drinking patterns can cause drinking behaviors because of the way the ethyl alcohol chemicals in alcoholic beverages interrupts the brain’s electro-chemical signaling process (aka neural networks – the way brain cells talk to one another) until enzymes in the liver can break down (metabolize) these chemicals to they can leave the body.

So, my “excessively drinking” loved ones and I had spent hours and then years and then decades arguing the finer points of their various drinking patterns. Each one denied their drinking was really that bad, and with each one, I denied to myself it really was out of their control. Instead, I rationalized their behaviors (and mine), saying things to myself like:

  • He stopped drinking for two years before, so of course he can control his drinking.
  • I drank. Sometimes I drank a lot and partied right along with him, but that doesn’t mean I have a drinking problem (or does it?)
  • It could be worse. At least she’s not mean when she drinks.

Fueling my rationalizations was the fact I had struggled with eating disorders (one year of anorexia and eleven years of bulimia starting at age 16 and lasting until age 28). I knew the self-loathing, the shame, the fear and the desperation my loved ones felt over breaking the promises they’d made to themselves to stop or cut back. I knew the insanity of wanting and believing each purge was the last, only to find myself crazed in a food binge two hours later, followed by the mental volley of rationalizations that eased my guilt. But, since I had learned to re-eat successfully on my own, I thought people who had problems with drinking could learn to re-drink. And so, over the years, my rationalizations morphed, absorbed, blurred and merged until I had simply made the unacceptable acceptable.

But back to that day in 2003.

I found myself plunged me into a whole other world. I was labeled a codependent and an enabler and told that I needed to get help. I was told alcoholism was a disease. [I really baulked at that one. “Cancer was a disease,” I would argue, “all they have to do is put down the bottle!”]

But I was also done – done – done with what I didn’t know, but I knew something had to change.

Fortunately, I took to heart what the treatment center’s family therapist said to do. I attended as many family group programs at the center as were available and started participating in Al-Anon, a 12-step program for family and friends of a loved one who misuses alcohol. I found a therapist who specialized in helping people on the family side of this disease and spent three years in Cognitive Behavioral Therapy (CBT) with him. I needed to unwire the many trauma/toxic stress-related unhealthy, reactionary coping skills I’d adopted in order to stay emotionally and physically safe in the almost four decades I’d spent grappling my loved ones’ drinking behaviors (what I refer to as SHD-related ACEs for reasons I’ll soon explain).

It was also in this therapy I discovered the full impact on me of the sexual assault by a boyfriend’s father when I was a teen and the cover-up that followed – another ACE/trauma (though I didn’t understand it to be ACEs, at the time). I had so deeply buried the stripping away of “Lisa” caused by that experience, thus healing that trauma (ACE) was as important as healing the trauma caused by secondhand drinking.

And in the midst of all this, I did what I do – I researched. I had to understand how I went so far down; why I’d tolerated my loved ones’ drinking behaviors for so, so long; and on what basis treatment professionals could possibly think alcoholism was a disease. What I have learned in the fifteen years since that fateful day in 2003 has been life changing, much of it related to the explosion in research findings about the live human brain thanks to advances in imaging technologies.

This research explains:

  • how the brain works, wires, develops, and maps to control everything we think, feel, say, and do and explains the habits, emotional coping skills, and routine behaviors we develop
  • how alcohol misuse, adverse childhood experiences/trauma, toxic stress, genetics, and environment can negatively change or influence that wiring, development, and mapping

Experiencing ACEs as a result of a family member’s alcohol use disorder and/or personally experiencing secondhand drinking or other family members’ SHD impacts can set a child up to develop an alcohol use disorder or marry a person with an AUD.

  • why alcoholism (aka alcohol use disorder/addiction) is a developmental, chronic brain disease that starts with alcohol misuse changing brain structure and functioning, making the brain more vulnerable to the key risk factors for developing the disease
  • why adverse childhood experiences/trauma can cause toxic stress; toxic stress can actually change a child’s brain architecture, negatively affecting their lifetime physical and emotional health
  • why a person must heal their trauma/ACEs in order to more fully heal their brain and thereby improve their lives
  • that the brain is “plastic,” meaning it can be rewired, it can heal from the impacts of alcohol use disorders and ACEs/trauma-related toxic stress and thus a person can change their habits, emotional coping skills, and routine behaviors
  • that nutrition, exercise, sleep, and mindfulness are critical to brain health and thus are keys to repairing, rewiring, and healing one’s brain for better thoughts, feelings, and behaviors
  • and so much more.

As important as these brain research advances were to my recovery was my learning about the CDC-Kaiser ACE Study. This study measured the impact of adverse childhood experiences (ACEs)/trauma on a person’s emotional and physical health across a lifetime. Finally! Something that explained what had happened to me AND to my various loved ones.

Understanding ACEs Put my Recovery Over the Top

By the time I learned about ACEs and the ACE Study, I’d done a tremendous amount of work to get to the core of the “real” Lisa – work that informs my professional work, as well. But as I explored my own ACEs, and then the ACEs of my mom, whose drinking had so influenced the trajectory of my life, using an ACEs Family Tree template I’d roughed out, it felt like the last of the shackles on my heart (my brain) broke.

My mom had five ACEs – three related to her own mom’s drinking and two that were not. Her mom had ACEs related to the deep dark secrets surrounding her birth and early childhood. My dad had ACEs/trauma, such as the accidental shooting death of his closest sibling by another sibling in a hunting accident when my dad was a teen. My grandfather had ACEs related to his being orphaned as a child and immigrating to America as a teen who did not speak English seeking work opportunities.

I used this same template to trace an ACEs Family Tree of some of my other loved ones, as well. One had five, another three, and a third six.

And all had long-term exposure to secondhand drinking.

Doing these ACEs Family Trees helped me understand it wasn’t just me or my various loved ones in my/their immediate family/ies. It was ACEs/trauma across generations. When a parent does not heal their ACEs/trauma, their experiences growing up with ACEs/trauma changes them. Those changes in them affect their parenting and/or inter-familial relationships in profound ways, which in turn affects how they parent or were in relationship with me and I with them.

It also helped me realize I could have developed alcoholism, myself. Instead, I developed eating disorders. Others in these ACEs Family Trees spiraled into deep depression, experienced great anxiety, coped by using explosive rages when angered or frustrated, or experienced a host of toxic stress-related ailments: headaches, digestive/stomach problems, skin rashes, cancer, chronic inflammatory conditions, migraines, and sleep disorders. Some, like myself, married alcoholics, which finally made sense to me because the interactions one has with a person with an alcohol use disorder after being raised in a family with a parent with an alcohol use disorder are “normal.”

And, it was by tracing my ACEs AND my mother’s and my father’s and my grandparents that I could really appreciate how strong and resilient my family members and I were/are. For in tracing my family ACEs history, I could recognize and honor that each generation had experienced their own ACEs – not necessarily the ones measured in the ACE Study but traumatic incidents, nonetheless – and still managed to structure a life that allowed them to push on, in spite of their ACEs. And in this manner, they passed along resilience, as well as ACEs, to the next generation.

But Why the Focus on SHD-Related ACEs?

As noted above, not all ACEs are related to SHD, of course. But I focus on SHD-related ACEs in this post for five reasons:

  1. because of my own experiences and wanting to help others avoid similar ones.
  2. having blindly participated in passing along the consequences of my own untreated ACEs to my daughters the same way my parents had blindly passed their to me. And these consequences to my daughters were not related to their developing alcoholism or an alcohol use disorder. Rather, they were the consequences of insecurity, anxiety, fear, anger, self-judgment, unclear boundaries, accommodating the unacceptable, constant worry, and the other physical, emotional and quality-of-life consequences of toxic stress. It was this shocking insight that moved me to fully treat my untreated ACEs and help my daughters treat theirs.
  3. because of the emails I receive from children like this one:
    I am 12 years old. I am asking about a parent who I think is an alcoholic…My mother has a hard time coping with drinking and usually gets drunk at home. She yells at me, and I get angry a lot. I have tried keeping my feelings aside from this, but it’s really hard. I keep thinking this is my fault, even though many websites say otherwise. There aren’t any places near to ask for help, but I cant talk to her about her getting drunk a lot. Thank you for taking the time to read this, and if you can, please tell me what I can do.
  4. the sheer numbers of children affected…
  5. to help break the familial cycles of alcohol misuse. Not only does secondhand drinking caused by parental alcoholism affect these 1 in 4 children, it affects their moms, dads, siblings, grandparents, etc. – those other family members who will, in turn, affect that child because of the way they behave as a consequence of how they’re coping with SHD and/or ACEs/trauma. In other words extending the ACEs/trauma within an immediate family and across generations. In total, it is estimated that 75 million Americans are affected by a loved one’s drinking behaviors (previously estimated to be 90 million based on previous National Survey on Drug Use and Health (NSDUH) data).

As Dr. Robert Anda, Co-Principal Investigator on the ACE-Study, writes in his paper, The Health and Social Impact of Growing Up With Alcohol Abuse and Related Adverse Childhood Experiences, “[G]rowing up with alcohol abusing parents is strongly related to the risk of experiencing other categories of ACEs.”

In other words, a parent’s alcohol misuse causes drinking behaviors; drinking behaviors cause secondhand drinking – the negative impacts of a person’s drinking behaviors on others, such as:

  • verbal, physical, emotional abuse;
  • neglect;
  • unpredictable behaviors;
  • parents separate or divorce;
  • alcohol-related domestic violence;
  • alcohol-related crime that results in incarceration.

These drinking behaviors, in turn, cause ACEs to a child, such as:

  • physical, verbal, sexual abuse
  • physical, emotional neglect
  • living with a problem drinker or alcoholic
  • parents separated or divorced
  • incarcerated family member.
  • domestic violence against one’s mother.

This connection between ACEs and SHD, in turn, sets up a person to have or develop several of the key risk factors for developing alcoholism (aka alcohol use disorder, addiction), which include:

  • childhood trauma
  • genetics
  • social environment
  • early use
  • mental illness – and guess what – many mental illnesses, such as depression and anxiety, are the consequence of toxic stress – the kind of stress a child experiences or a non-drinking parent married to an alcohol misusing parent experiences.

Which brings me to my premise…

Tracing One’s Family ACEs Tree Can Help Break the Familial Cycle of Alcohol Misuse

My mom didn’t stop drinking until age 79. She died at 84. There was no warning, no lingering illness. She died two days after an unsuccessful emergency surgery. But we had five years during which she did not drink, after forty-five years during which she did. Ironically, my mom was also a 17-year cancer survivor when she died. I write, ironically, because it’s now scientifically understood that cancer and alcoholism are both chronic diseases – disease that can successfully be treated.

During the last years of her life, my mom and I talked a great deal about the work I’d been doing since 2003. She’d known the gist of it. I had offered her my expertise and help over the years and couched it in terms of the other alcohol misusers in my life’s experiences and my own secondhand drinking experiences and eating disorders. She’d get uncomfortable and gloss over my giving a presentation or completing a book on an addiction-related topic with a vague, “That’s nice dear. I’m happy for you.” There were times after a particularly bad bout or a disastrous consequence of drinking that she’d express a willingness to get help, but she never wanted to go to rehab, nor back to AA, something she’d tried early on.

But after she stopped drinking in 2011 and had some months of clarity, she didn’t cut me off as I shared a new talk or blog post topic.

She eventually started asking questions and was especially taken with the ACE Study and adverse childhood experiences. As we talked over time, she came to understand and appreciate that adverse childhood experiences cause toxic stress and that toxic stress can actually change a child’s brain architecture, negatively affecting their lifetime physical and emotional health. She loved my concept of secondhand drinking.

But it was the connection between ACEs and SHD and how they set up the key risk factors for developing addiction (of which alcoholism is one, aka alcohol use disorder) that rocked her world the way it had rocked mine. It was this connection and finally understanding that alcoholism (addiction) is a brain disease that set her free to forgive herself the way I’d forgiven her years before. She didn’t “choose” to become an alcoholic just as she didn’t “choose” to have breast cancer; nor was she weak-willed, immoral, uncaring or any of the other adjectives used to label persons with this particular disease.

I invite you to use the template I’ve created to trace your or a loved one’s Family ACEs Tree (click here to download) in hopes it can help you break the familial cycle of alcohol misuse in your family or some other familial cycle related to ACEs. It can also be shared with community leaders, teachers, church leaders, and medical professionals — anyone and everyone who comes in contact with a child experiencing SHD-related ACEs/trauma and/or their parent, sibling or grandparent.

And please know that I am not suggesting that just because one knows their Family ACEs Tree excuses or minimizes or erases the impacts of their own ACEs, nor does it stop the triggers one still experiences as a consequence of those ACEs. Rather it can help with the healing process, with developing self-soothing techniques to counter those impacts, and in time, to forgive — to forgive oneself and those whom hurt them so deeply. And that forgiveness can be as simple as letting go of the yearning for a different outcome by understanding that everyone was doing the best they could with what they knew at the time — which was likely zip, zilch.”

To close this post…

I want to share one of my mom’s greatest gifts to breaking the cycles of untreated SHD-related ACEs and untreated ACEs in general. It happened during one of our phone calls.

She said to me, with deep emotion, “Lisa – please – please use my story – our story – to help others.”

And so I am.

There wasn’t enough time for my mom to heal from her ACEs, nor for she and I to develop the mother/daughter relationship I now have with my two daughters. Our experience is so different because of the healing work the three of us were able to do to break this cycle.

But my mom started her process by breaking the denial, secrecy, lies, and self-judgment about her alcoholism and its root causes – ACEs. And it is the four of us together – my mom, myself, and my two daughters – who have now changed the legacy in our family by identifying and treating our own ACEs outcomes. As such, we pass forward not lies but the truth, not self-judgment but self-compassion, not secrecy but openness, not denial but seeking awareness. Something I didn’t even understand, let alone could have imagined possible, in 2003.

Additional Resources

National Association for Children of Addiction (NACoA) https://nacoa.org/

National Institute on Drug Abuse (NIDA) > Drugs, Brains and Behaviors: The Science of Addiction

ACEs Connection > ACEs Science101 FAQs

ACEs Connection > Parenting With ACEs

Substance Abuse and Mental Health Services Administration (SAMHSA) > Understanding Child Trauma

©2018 Lisa Frederiksen

Lisa Frederiksen

Lisa Frederiksen

Author | Speaker | Consultant | Founder at BreakingTheCycles.com
Lisa Frederiksen is the author of hundreds of articles and 12 books, including her latest, "10th Anniversary Edition If You Loved Me, You'd Stop! What you really need to know when your loved one drinks too much,” and "Loved One In Treatment? Now What!” She is a national keynote speaker with over 30 years speaking experience, consultant and founder of BreakingTheCycles.com. Lisa has spent the last 19+ years studying and simplifying breakthrough research on the brain, substance use and other mental health disorders, secondhand drinking, toxic stress, trauma/ACEs and related topics.
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4 Comments

  1. Edwin on May 2, 2018 at 7:43 am

    Thanks for sharing Lisa. Never heard of Alcohol Use Disorders (AUD), Secondhand Drinking (SHD) and ACEs before. Glad to learn this knodledge from you. And also the Family ACEs Tree template is very useful.

  2. Michael J. Syrduka on June 13, 2018 at 4:15 am

    I got to know about AUD when I took a cousin of mine for rehabilitation at a center in Orlando, FL. He was deeply involved in alcoholism after he lost his job that he labored to build his career on. He lost his mind, battered his wife many times and made his kids cry. It was so horrible for him. The fact is that millions of people are struggling with addiction to powerful alcoholic and drugs substances, hundreds of thousands are daily seeking treatment to overcome it. I have seen many people including my cousin who has found success and is now better people. Thank you for this enlightening write-up. It will be of help to many alcohol addicts to discover themselves, seek help and recover from it.

    • Lisa Frederiksen on June 13, 2018 at 4:56 pm

      You are so welcome, and thank you for sharing your thoughts and comment, Michael.

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