LESSON PLAN ON ALCOHOLISM AND CODEPENDENCE
in conjunction with
"When a Man Loves a Woman"
Answer Key to Unit Test and Suggested Responses to Discussion Questions
Unit Test on Alcohol Abuse, Alcoholism and Codependence
A. Why is it not safe for a pregnant woman to drink any alcohol? Suggested Response: Alcohol is a poison that stays in the blood of the mother until her liver breaks it down into harmless substances. Alcohol in the mother's blood crosses the placenta and reaches the fetus. The fetus is growing so quickly that the presence of any alcohol can affect the development of nerve cells in the brain.
B. What is moderate alcohol consumption for an average sized woman and an average sized man? Suggested Response: Moderate alcohol consumption is no more than one drink per day for an average sized woman and no more than two drinks per day for an average sized man.
C. Abuse of alcohol by both alcoholics and non-alcoholics often contributes to injury and property damage. Which contributes to more injury and property damage than the other? Suggested Response: Abuse of alcohol by non-alcoholics causes more injury and more damage to property than abuse of alcohol by alcoholics.
D. What are the three primary effects of alcohol consumption on our brains? Here are some hints. One is the slowing of something that allows us to avoid being injured. Another is the reduction in an ability to do things, such as walking, manipulating things with our hands, and safely driving a car. The third effect of alcohol relates to something we rely on to avoid doing things that are unintelligent or wrong. Suggested Response: The three primary effects of alcohol consumption on our brains are: 1) it slows our reaction time; 2) it reduces our coordination; and 3) it impairs our judgment about what the consequences of our actions will be and what is right and wrong.
E. As a result of the three primary effects of alcohol on our brains, alcohol consumption by teenagers increases the risks of four types of very unpleasant and dangerous events. List them out in sentence form. Here's a hint. Three of these risks begin with an "A" and one with an "S". Suggested Response: Alcohol consumption increases the risk of the following events: 1) an accident that could cause injury or death; 2) carrying out a physical or sexual assault; 3) being the victim of a physical or sexual assault; and 4) engaging in risky sexual behavior leading to unwanted pregnancies and transmission of STDs, including HIV.
F. What is it about the brains of teenagers and young adults that makes alcohol abuse more dangerous for them than for mature adults? Suggested Response: Alcohol abuse is particularly more dangerous for teenagers and young adults than for mature adults because the brain continues to develop into the mid-20s and alcohol abuse can cause permanent changes in the structure and function of the developing brain. A good alternate answer is that it impairs judgment more in teenagers and young adults because the judgment centers of the brain are not fully developed until the mid-20s.
1. There is an old saying that every time a person dies an entire universe is destroyed. With that in mind, answer the following question. Alcohol consumption contributes to approximately ___________ deaths from traffic accidents in the U.S. each year. Choose your answer from among the following possibilities: approximately 10,000, 12,000, 15,000, 17,000 or 20,000. Suggested Response: 17,000.
2. Alcohol consumption contributes to approximately ______________ serious injuries in the U.S. each year. Choose your answer from among the following possibilities: 300,000, 350,000, 400,000, 450,000, 500,000. Suggested Response: 500,000.
3. Assault can cause serious physical injuries and is a major cause of post traumatic stress syndrome, which can affect a person for the rest of his or her life if left untreated. Alcohol consumption contributes to approximately _____________________ assaults in the U.S. each year. Choose your answer from among the following possibilities: 500,000, 550,000, 600,000, 650,000, 700,000. Suggested Response: 600,000.
4. Sexual assault is a particularly vicious form of assault because it focuses on what should be the means of expressing affection. Alcohol consumption contributes to _____________________ sexual assaults in the U.S. each year. Choose your answer from among the following possibilities: 45,000, 50,000, 55,000, 60,000, 65,000, 70,000. Suggested Response: 70,000.
5. Alcohol is a factor in ________________________ deaths among young people in the U.S. ages 15 to 19. Choose your answer from among the following possibilities: "one out of two", "one out of three", "one out of four", and "one out of five". Suggested Response: One out of four.
6. Alcohol is a central nervous system depressant. This means that alcohol causes our brains to operate _______________________. Suggested Response: More slowly or at a reduced rate of speed.
7. What percent of the population in the U.S. is alcoholic? ______. Choose your answer from among the following possibilities: 5.0%; 5.5%; 6.0%, 6.5%, 7.0% or 7.5%. Suggested Response: 7.5%.
8. ______________ children in the U.S. are affected by alcoholism or alcohol abuse in a family member. Choose your answer from among the following possibilities: "one of two", "one of three", "one of four", and "one of five". Suggested Response: One of four.
9. Approximately _________________ children are born with Fetal Alcohol Syndrome (FES) in the U.S. each year. Choose your answer from among the following possibilities: 40,000, 50,000, 60,000, 70,000. Suggested Response: 40,000.
10. Children of an alcoholic parent are __________________ to be beaten or sexually abused than other children. Choose your answer from among the following possibilities: more likely or less likely. Suggested Response: More likely.
11. When did Mary, the alcoholic woman whose situation was described in the handout, "hit bottom" and join Alcoholics Anonymous? Was it when she lost her job, when she bit her favorite nephew while she was in a drunken rage, or when she woke up in a hospital room with a broken collarbone, no memory of how she had fallen, and no idea where she had left her beloved dog? Suggested Response: Mary hit bottom when she woke up in a hospital room with a broken collarbone, no memory of how she had fallen, and no idea where she had left her beloved dog.
12. Mary has been in recovery for fifteen years faithfully going to AA meetings several times a week. She has not had a drink of alcohol in all this time. What, if anything, happened to Mary's desire to drink alcohol? What will most likely happen in the future with respect to this? Suggested Response: Mary has not lost her desire to drink alcohol and most likely will never lose that desire. All that she can do is refuse the urge to take that first drink.
13. Doctors tell us that alcoholism is a progressive disease. What do they mean by this? Suggested Response: It doesn't get better without treatment; it just gets worse and eventually, if left untreated, it will result in death.
14. Al-Anon is a self-help group for adult family members of alcoholics. What is the name for the self-help group for teenagers with a parent or family member who is an alcoholic? Suggested Response: Alateen is a self-help group that assists teenagers who have an alcoholic parent or family member.
15. When psychologists are trying to determine whether a person is an alcoholic, they look for five symptoms. One of the symptoms is an increasing tolerance for alcohol so that the person must drink more to feel the effects of the drug. List three of the others. You will get extra credit if you can list a fifth. Suggested Response: The four other symptoms of alcoholism are: (1) craving: a strong need or urge to drink; (2) loss of control when drinking: not being able to stop drinking once drinking has begun; (3) loss of independence from the drug: continued abuse of alcohol despite harm or personal injury; and (4) physical dependence: withdrawal symptoms such as upset stomach, shakiness, sweating, and anxiety.
16. What is "hitting bottom" for an alcoholic and what is the importance of hitting bottom? Suggested Response: "Hitting bottom" occurs when things get so bad for an alcoholic that he or she realizes that drinking alcohol is intolerable and makes a fundamental decision to fight the addiction.
17. One of the indicators that a person has a drinking problem is when other people tell that person that they think he or she has a drinking problem. There are four other indicators. List at least two of them. If you can list one or two more, you'll get extra credit. Suggested Response: Indicators that a person has a problem with alcohol are: (1) you drink alone when angry or sad; (2) drinking makes you late to work or school; (3) you forget what you did while drinking; and (4) you get headaches or a hangover when you stop drinking.
18. Define the term "enabling behavior" and give two examples of types of enabling behaviors. Suggested Response: Enabling behavior is when a non-alcoholic protects the alcoholic/addict from some of the unpleasant consequences of intoxication. The following types of enabling behaviors are listed in the handout: (1) fixing problems caused by intoxicated behavior and helping the alcoholic/addict get out of trouble caused by the addiction; (2) cooperating in the alcoholic/addict's denial that there is a problem; (3) helping the alcoholic/addict hide addictive behavior and its effects from others; (4) providing financial support for the addiction; and (5) avoiding making friends or bringing people home who might not be in on the "secret".
19. What is codependence? Suggested Response: Codependence occurs when a family member (1) gets psychological gain from enabling behaviors or an altered role in the family caused by the substance abuser's behavior and (2) has developed an emotional need to enable the addictive behavior even when he or she sincerely objects to it. Codependence is itself a psychological condition that needs treatment.
20. How does a parent's alcoholism or drug addiction injure his or her children? Suggested Response: A strong answer will contain many of the following concepts. Children need consistent caring interactions with their parents in order to learn how to have trusting relationships with others. Alcoholics/addicts cannot consistently act in a caring way. People cannot rely on them. Their commitment is to the feelings that the drug unleashes when they take it. When people are intoxicated their behavior is erratic and they cannot focus on the needs of a child. No matter how much a parent loves a child, if that parent is an alcoholic/addict, there will often be times when the parent chooses intoxication over the needs of the child. Not being able to trust their parents, children of alcoholics often have trouble trusting others. Frequently, the mixed messages received from their parents also cause children of alcoholics to suffer from low self-esteem and various psychological disorders. Another way to approach answering this question is to focus on the dysfunctional roles that a child in a family that includes an alcoholic might adopt. These include "Enabler in Chief", "Family Hero", "Lost Child", "Mascot" or "Scapegoat". A strong answer would explain how each of these roles develops and how they can prevent the child from attaining self-actualization.
21. Describe what is meant by the term "Enabler in Chief" and how that role can harm an individual in a codependent relationship. Suggested Response: A strong response will include the following concepts: (1) an Enabler in Chief is the codependent person who takes primary responsibility for protecting an alcoholic/addict from the consequences of intoxicated or out-of-control behavior; (2) The Enabler in Chief is injured by giving up goals in his or her own life for the benefit of the alcoholic/addict.
22. Describe what is meant by the term "Family Hero" and describe how the role of Family Hero will be damaging to a child in a codependent relationship. Suggested Response: A strong response will include many of the following concepts. The Family Hero tries to act perfectly and do everything right. When the Enabler in Chief and the substance abuser are married, the Family Hero is often the oldest child. A child Family Hero makes good grades, seldom gets into trouble, and almost never does anything to cause the non-addicted parent (the Enabler in Chief) pain or distress. The child Family Hero thinks that if only he or she were perfect, the addicted parent would reject intoxication and become the parent the Family Hero always wanted (and was entitled to). A child Family Hero cannot speak up for his or her own needs or desires and is motivated by fear of further disruptions in the family system. The fundamental problem with the role of the child Family Hero is that this person is acting as the perfect child for the benefit of others, rather than for the purpose of self-actualization. Some child Family Heroes, who are fully involved in codependence, don't know what they want in life. Moreover, child Family Heroes are bound to be frustrated because an alcoholic/addict will not stop drinking or using because a child acts perfectly. Nor will having a perfect child make up for the sacrifices and losses of a parent Enabler in Chief. The only way to be a true Family Hero is to recognize the alcoholic/addict for what he or she is, to stop all enabling and codependent behaviors, and to take the route of self-actualization.
23. Describe what is meant by the term "Lost Child" and how that role can cause harm to a child. Suggested Response: To avoid causing problems and to help the family system maintain a balance, some children avoid getting in the way and give up any effort to get their own needs met. An alcoholic/addict parent will be absorbed with getting high and avoiding the consequences of the intoxicated life. An Enabler in Chief parent might be so focused on protecting the substance abuser that he or she will not have time or energy to nurture this child. Rather than demanding attention, acting out, or rebelling, and instead of becoming a Family Hero, the Lost Child simply retreats into him or herself. A Lost Child will often have terrible problems with self-esteem and in developing healthy relationships with others.
24. Describe one reason relating to enabling behaviors that causes marriages or romantic relationships to break up when one member of the couple enters recovery. Suggested Response: The answer should contain the following information: If the alcoholic/addict enters recovery and starts to assume a more equal and competent role in the family, relationships with family members that were based on the addiction must be adjusted. A recovering drug addict or alcoholic will not accept the enabling behaviors that he or she had previously sought. Changing patterns of relating to each other that have been set for years is difficult for any couple. Many marriages and romantic relationships cannot adjust to the recovery process and the couples separate or divorce.
Social-Emotional Learning Discussion Questions:
ALCOHOL & DRUG ABUSE
The following three questions should be asked together.
1. How did Michael enable Alice's drinking? Suggested Response: Here are four examples; there may be more. As students give the examples, ask them why this particular behavior was enabling rather than nurturing. The answer is that enabling behavior is conduct that might otherwise be considered nurturing but which helps the alcoholic/addict avoid the consequences of an intoxicated lifestyle. 1) By taking care of Alice ("wringing her out") at the end of many evenings when she got drunk and passed out; 2) by partying with Alice when she got drunk and appreciating her wild drunken behaviors, like when he joined with her in throwing eggs at the car (an illegal act; dried egg will destroy the finish on many cars requiring an expensive repair); 3) by rewarding Alice with a vacation trip to Mexico for going out with a girlfriend, getting drunk, not calling anyone, and causing him to miss work; and 4) by interceding in Alice's disagreements with the children when she had a hangover.
2. Give an example of an action in which Michael saved Alice from the effects of her intoxication in which he was not enabling her alcoholism. Suggested Response: Here are four examples; there may be more. As students give these examples, ask the students why this particular behavior was not enabling behavior. The answer is that these actions were necessary to protect her from risk of injury or death or as to #3, it was meaningful action to help her stop drinking. (1) Rescuing Alice from drowning when she fell out of the boat; (2) letting Alice back into the house when she locked herself out in the middle of the night; (3) taking her to the rehab center; and (4) calling someone to help her when she fell out of the shower.
3. [This question may have been answered when discussing the two preceding questions. If not, ask it in this form.] How can you tell the difference between nurturing or life-saving behavior and enabling? Suggested Response: It depends on the situation and it's not always easy. Most enabling actions are loving and nurturing if they are not taken in the context of permitting someone to live a life characterized by repeated intoxications. Bringing Alice a hot drink in the morning would not normally be enabling activity. Smoothing the waters and calming everyone down when a spouse is about to be too harsh with one of the kids, in most circumstances, is not enabling activity. Taking a vacation to get away from pressures that are weighing someone down is not usually enabling and can often be a good thing. However, in the case of Michael and Alice, these were occasions when he was playing Mr. Fix-it and allowing Alice to avoid confronting the consequences of her addiction. (Also, note that reasonable minds could differ on these questions. A good argument could be made that taking the vacation to Mexico was not enabling activity.) Obviously, Michael couldn't have let Alice drown with the excuse that he was just enabling her alcohol abuse by saving her.
4. One of the people at the treatment center said to Michael, "Your wife is a very comforting person." Why did the screenwriter have this character say that? Suggested Response: Alice had not been shown to be particularly comforting before. In their relationship it was Michael who took care of people. However, Alice always had this ability. Remember, Alice was a school counselor and she listened to her friend for hours. However, she was not exercising that ability in the relationship with Michael. This scene shows that Alice is beginning to be able to stand on her own two feet and to help other people.
See the Quick Discussion Question. Questions A - E and 14 - 24 in the unit test are also good to review with students or to spark discussions.
5. Michael tells Alice: "If my wife hurts, I need to say, 'What's wrong honey? [Is there] something I can do and I love you.'" When in the movie does Michael make this statement and what is going on in this conversation? Suggested Response: This dialog occurs after Alice has been released from the rehab center and while she is in the early stages of recovery. She is trying to readjust her relationship with Michael. Previously, Michael (at Alice's invitation and with her encouragement) had developed many enabling behaviors in which he would try to assuage her pain and fix the problems caused by her intoxication. In this conversation, Alice is trying to tell Michael, not very articulately, that since she is in recovery, she cannot tolerate this type of behavior anymore. He protests with the agony of the family member of an alcoholic/addict. Caring means trying to help when something is wrong, but that doesn't always work with an alcoholic/addict. When the alcoholic/addict is still using the drug, the enabling behavior allows the alcoholic/addict to avoid facing up to the need to kick the habit. When the alcoholic/addict is in recovery, repeating enabling behaviors could lead back to using the drug.
6. Alice tells Michael: "I'm just hanging on here." When in the movie does Alice make this statement and what is going on in this conversation? Suggested Response: This is at the beginning of her recovery when she is not used to resisting the craving to take a drink. She is trying to tell Michael that she is at great risk of drinking again.
See Question # 20 in the unit test.
7. Describe how Alice's alcoholism affects her children. Suggested Response: The movie shows Alice being unable to help the children in the morning after the anniversary dinner; causing the children to worry when she is sick after being intoxicated and when she passed out; being irritable with Jessie when she has a hangover; and slapping Jessie. These conditions will cause Jessie psychological problems in the future. See also the response to unit test question #20.
See the Quick Discussion Question and Question #24 in the unit test.
8. Alice says, "I'm going to disappoint him. This is not the person he married. I'm not going to be fun." What does this dialog refer to? Suggested Response: It refers to the fact that the alcoholic and the non-alcoholic members of a marriage or romantic relationship develop patterns of satisfying each other's needs and that when this is disrupted, either partner justifiably worries that he or she will no longer be loved.
9. Alice says, "I told him it made me feel small and worthless when he tried to help. I shut him out because I knew that if he saw who I was he wouldn't love me." What does this dialog refer to? Suggested Response: It is normal for an alcoholic, a person who usually has low self-esteem, to fear that they are not lovable. The fear increases as the alcoholic/addict enters recovery. He or she fears that it was the addicted behaviors that the other person liked.
10. Alice engineers a situation in which Michael moves out of the house. (She didn't come out and ask him to leave. However, she knows that Michael will leave when she tells him that he makes her skin crawl. Also, when he says he is going to leave she doesn't discourage him.) Why did she do this? Suggested Response: There are several possible strong answers. Here are two. Alice needed a break in their relationship to reevaluate it. She needed for them to start again without the enabling behaviors but this couldn't happen until they were apart and then came together again under a new arrangement.
11. Compare Michael's feelings for Jessie to the way he felt about his biological daughter Casey. Suggested Response: We favor the following response: He loved them both as his children. Caring for a child comes from raising the child, not from genetics.
Moral-Ethical Emphasis Discussion Questions (Character Counts)
Discussion Questions Relating to Ethical Issues will facilitate the use of this film to teach ethical principles and critical viewing.
(Be kind; Be compassionate and show you care; Express gratitude; Forgive others; Help people in need)
1. How does caring about an alcoholic/addict lead to enabling behaviors? Suggested Response: Alcoholics/addicts manipulate family members and friends into behaviors that enable the alcoholic/addict to continue with their addiction. They are able to do this because no one wants to see a loved one become homeless, go to jail, become unemployed, or suffer the other unpleasant consequences of the uncontrolled use of intoxicants. But sometimes not helping is the most caring thing to do.
Last updated June 14, 2008.
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