“He is lovely and awful”: The challenges of being close to an individual with alcohol problems

Introduction: In the last 20 years, there has been growing evidence that heavy drinking causes serious harm not only to the person who drinks but also to the person's relations and concerned significant others (CSOs). A relationship with a heavy drinker is often full of conflicts, and CSOs are frequently exposed to aggression, psychological, and sometimes physical violence from the heavy drinker. Despite their struggles, CSOs often feel it is difficult to seek professional help for these problems. The aim of this study was to investigate what problems CSOs of people with alcohol problems experience prior to seeking professional help to handle these issues. Moreover, to investigate what led to seeking professional help at all. Methods: This is a qualitative study with 12 female help-seeking CSOs of persons with alcohol problems. The participants were recruited from a randomised controlled trial (RCT) on Community Reinforcement and Family Training (CRAFT). Semi-structured interviews were conducted, audio-recorded, and transcribed. The analysis was based on interpretative phenomenological analysis. Results: Three overall themes and one sub-theme emerged from the analysis: (1) The CSO’s feelings and experiences of the situation prior to help-seeking, (2) The relationship with the drinker, (3) Reasons for help-seeking and its trajectory; and the sub-theme, What the CSOs hoped to gain from help-seeking. Conclusion: The present study showed that female CSOs of people with alcohol problems had suffered for a long time before seeking professional help. They felt their daily lives were unpredictable and stressful. They were often exposed to verbal and mental abuse and their relationships with the drinking relative were often characterised by frequent rowing. The CSOs had tried to cope for a long time using a number of different strategies; seeking help seemed to be the last option considered. Despite all the struggles and pain, the CSOs also felt a lot of love for their drinking relative and hoped for the return of their once sober relative. Our findings can be viewed as a support to the stress-strain-coping-support (SSCS) model proposed by Orford and colleagues.