A study of the family during separation from and reunion with an alcoholic husband
Previous research has shown that the family system can undergo considerable reorganisation as a result of 'crisis’ experiences, and that the extent of the distress experienced by members is related not only to the severity of the crisis, but also to the resources which the family has at its disposal for adapting to the crisis, and to the family members' perception of the crisis event. The hospitalisation and the return of an alcoholic husband were taken as examples of the application of stress to the family system. Research on families in crisis has concentrated upon situations of financial deprivation and war separation. While the hospitalisation of mental patients has been investigated, in such studies the emphasis has not been upon the family. The present study was of an exploratory nature, with the aim of seeking to establish regularities within the adaptation patterns of the families and illustrate their relationship to the changes in the drinking patterns of the alcoholic husbands. Previous reports on the adaptation of the families to the 'crisis' of economic depression and war separation were used to obtain indications of factors important to the adaptation of families to stressors. In constructing a picture of the family in 'crisis', the following sources of data were used: 1. Questionnaires and scales - these were used to measure spouse perceptions, attitudes of family members to alcohol-related issues, structural and syntality variables relating to the family, marital adjustment, personality dimensions of the spouses, involvement in role-tasks, participation in the society, and sources of conflict. 2. Sociometric devices - to determine the degree of emotional involvement of members in the family, and relationships between family members. 3« Interview material - this material was obtained in a loosely structured interview. Questions focussed on family functioning and modes of adjustment. 4. Case material - while not providing the basis of the study, case material was used to illustrate and illuminate the trends which emerged from other data. It was also used to provide correlates for quantitative changes on individual and family dimensions. Two groups of alcoholic patients, all of whom were husbands in intact families, were taken. In the first group (Group 1 ) the patients were admitted for three weeks to a hospital a few miles from their homes. Husbands in the other sample (Group 2) were admitted for three months to country mental hospitals, so that, with the exception of letters, isolation from the family was virtually complete. Regular contact (visits by the author about every six weeks) was maintained with the alcoholics and their families for between eleven and fifteen months after the hospitalisation of the husband, There was little difference between Group 1 and Group 2 husbands on variables considered to be related to the degree of pathology exhibited, but there were differences between Group 1 and Group 2 families. In comparison with Group 1, Group 2 wives were more ready to initiate hospitalisation of the husband, saw their husbands and their marital situations as less desirable, were less optimistic of their husbands’ being cured, less concerned for their husbands’ health, and yet more indulgent to their deviant drinking behaviour. It was found that in terms of the spouses’ attitudes to the family and to alcohol-related issues, there was little long term change as a result of the husband’s period in hospital. Considerable short term change was displayed by Group 1 husbands for a period after discharge, but the change was not maintained. The small long term changes which did occur bore little relation to the husbands’ change in behaviour. Modification in the structure of the family during the absence of the husband was also minor. In Group 2, where the husband was absent for a long period, those wives not already working sought at least part-time employment, and there was a tendency to neglect those household tasks traditionally the husband’s. Where there were older children in the family these spent more time in looking after younger siblings. Children carried out more of the household tasks (cooking, cleaning and washing up) than they did before the father's absence. Despite the general stability of role structure in the families, there was a considerable amount of difficulty experienced by the wives when coping in the separation situation. The factor reported as causing the most difficulty was inadequate finance, although the situation in most families was judged not to be critical by the author. In Group 2, the absence of the husband failed to lead to greater unity of effort or cohesion among remaining family members. In Group 1, however, where the husband was already at home when the retest of group characteristics was made, there was an increase in cohesion, and a significant number of families showed increased unity of effort. Families displayed a high level of conflict at hospitalisation. The main sources of conflict were the husband's drinking pattern, financial matters, (lack of) recreation, health (of the husband), and sexual adjustment. By the end of the study the level of conflict was reduced, possibly because the visits of the author facilitated discussion of areas of conflict. Conflict in the family at hospitalisation was related to a low level of united family effort to achieve goals, and a low level of cohesion. Husbands gave more favourable reports concerning their own personality characteristics, and the situation in the home at hospitalisation, than did the wives. They reported less conflict, better marital adjustment and a greater degree of happiness. Attitudes of the children to the father either agreed with those of the wife or fell between those of husband and wife. In attitudes to their parents, children in no case agreed with their fathers, although a number agreed with their mothers. Many of the families displayed a schism, with the husband a virtual isolate with regard to emotional integration, and failing to perform his role tasks adequately. Husbands were in conflict with adolescent children, particularly sons. The main source of conflict was the husband's contention that the children were indulged to an extent far exceeding that which the husband experienced in childhood. While there may have been some truth in this claim, the husbands themselves were spoiled and 'mothered' by their wives. Many of the wives in this study appeared to have strong needs to 'mother' and organise. While conflict in the families was at a high level, there were no effective efforts to reduce this. Little conflict resolution was attempted by discussion. The wives were the decision makers, and if they appeared to give in when arguing with the husband it was for 'peace and quiet'. The wives took the responsibility of representing the family to the community and of making plans affecting the families. This situation existed throughout the study. The families were isolated from the society, having little contact with relatives, and few effective friends. Stigma was not experienced as a result of the husband's admission to hospital, but the wives were embarrassed and ashamed of their husbands’ behaviour when drinking. With the husband absent, Group 2 wives spent more time at home with the family, and less in activities with family members outside the home. At the same point of time, with the husbands at home, Group 1 families showed an increase of social activities outside the home, and a slight reduction in home-centred activity. At the end of the study Group 2 wives displayed increased social activities outside the home, and reduced home-centred activity. The return of the husband did not mean an independence of social service benefits, since some husbands did not work, or deserted the home, and patients who were eligible for Repatriation benefits returned to hospital rather than remain in the home. The departure and return of the alcoholic husband did not lead to major reorganisation in the study families. It was shown that these families had already, before the study, adapted to the husbands’ malfunctioning, and exhibited role dislocation. Thus his absence necessitated little further role disruption. The families nevertheless experienced stress, but this appeared to result from the low level of family resources available to cope with the stressor. Data from the study were factor-analysed and from family factor scores, a family typology was derived. One type was approximately equivalent to Group 2 (Type A ) , one to Group 1 families with children (Type B), and one to Group 1 families without children (Type C). During the complete study there was little modification of the husbands’ drinking behaviour, so that it was difficult to relate this to other factors in the families. Improvement in the behaviour was related to the readiness of the husband to admit the fact and consequences of his drinking behaviour. It was concluded that neither the anxiety and low self-evaluation characteristic of the alcoholic, nor his deviant pattern of drinking were significantly modified by hospitalisation. The families did not require radical reorganisation in order to function during the absence of the husband, since much reorganisation, with the transferral of instrumental tasks to the wife, had preceded the hospitalisation* The families nevertheless experienced difficulty in coping during the separation» These families lacked the strong family resources shown by other studies to assist in meeting crises* They were of low morale, and members were frustrated and confused by the behaviour of the husbands, and by the lack of acceptable, established societal patterns of dealing with the problem. In the present study role disruption was shown to be not the basic stressor and this fact was related to the extent of role dislocation in the families at the beginning of the study, and the low level of resources in the families.
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