The issues surrounding addiction are very different for women than they are for men.

It would seems

sensible, in light of this, that treatments for addictions would then, be gender specific. In the case of

eating disorders, the treatment options come from the female perspective as the overwhelming number

of those suffering from eating disorders are women. When, however, it comes to drug and alcohol

addiction, the treatments are generally based on male models. The fact that women suffer from the

abuse of alcohol, drugs, sex, food, gambeling etc. is a dirty secret, something to be well hidden.

Women are mothers, wives, lovers, caregivers, and caretakers. The are not supposed to be alcoholics

or drug addicts --- who would take care of the kids?

The topic of addiction, especially drug and alcohol addiction and women is one of stigma and

denial. Women have a lot to loose and they have always known this. The bottom line for women and

addiction is that they can loose their children, their families and the respect of the community.

Addiction in women is a place reserved for shame and, therefore, denial. The reason why women do

not confront their addiction is this denial. The stakes are so high that a women knows to admit

addiction is to risk loosing --- everything. Stephanie Covington, in her 2000 article outlining her

treatment program for recovering women remarks, “the issue of women's addictions is not new, but

until recently it has been characterized by silence” (pg. 99). Women's problems with addiction and

abuse have remained, for the most part until now, invisible.

Hisorically, women who are addicted to either alcohol or drugs were not perceived to be

feminine. They were promiscuious. They neglected children. These addicted women were not docile

or submissive. They were not responsible wives or mothers. Their behaviour was considered both

deviant and unrestrained. This has been the public perception of alcoholic and drug addicted women.

But the silence and isolation could not last forever. The problems facing women and addiction were

becoming undeniable. Speaking of alcohol alone, there are a

projected of these women in the United States alone today. These women were being seen

and they were our mothers, our sisters, our wives and the mothers of our children.
 In the early 1900's women suffering with addictions could be put in “insane asylums”. They

were given involuntary hysterectomies. Women were not allowed to be seen drinking of television

until the fifties. In 1994, a study of male and female college students, revealed that if a woman in a

rape case had been drinking, the use of alcohol was enough to imply consent. And, as recently as 2002

with the increase of the number of children being born to chemically dependent mothers, the program

known as C.R.A.C.K. (Children Requiring a Caring Kommunity offered to pay abusers for voluntary

sterilization or long-term birth control methods. The cost of a voluntary sterilization was $200 cash

accompanied by the appropriate paperwork or $200 yearly for those choosing a variety of birth control

methods as long as the care was proven to be consistent. Clearly we, as Dorothy in The Wizard of Oz,

remarked, “we are not in Kansas anymore”(Flemming, V. director, 1939).

When E.M. Jellinek did his research about addiction and recovery to form what is now known

as the Jenninek Curve, the responses he got from women regarding their recovery was so different from

the information Jellinik received from male respondents that Jellinek threw the data received from

women out. Thus, what Covington refers to as the two “cornerstones of alcohol treatment programs”,

AA and the Jellinek curve, were based entirely on data received solely from men (pg. 100). It was

difficult at first to percieve, perhaps because the women involved were forced into hiding their

addictions, but what was working for men did not seem to be working for women. The focus of this

present work will be women and addiction to alcohol and the particular implications The Relational

Model of the Stone Center at Wellsley in the late 1970's has had on this field.

The authors of a 2002 article profiling a biosychosical perspective on woman and alcohol

speaks of the paradox the addiction of women and alcohol presents. It is the paradox of women and

alcohol that causes one to pause. Women often enter into a 'relation' with alcohol for the very same

reasons this 'relationship' presents a risk for them. Stress and distress are often cited among the

reasons that women turn to alcohol. There is significant research which links alcoholism in women to

abuse and neglect in childhood. Paradoxically, alcoholism is also linked to the neglect and abuse of the
children of alcohol abusing mothers. Many women drink to escape the trauma of turbulant childhoods

while their alcoholism breeds chaos and turbulance in their own homes. Poor self-esteem may lead a

woman into alcohol abuse. While the shame and stigma attached to the woman alcoholic lowers the

woman's sense of self even more. Women drink to lessen their feelings of depression and anxiety. All

the while, the shame they feel as the result of their addiction allows these secondary diagnoses to

kbecome worse and deepen. Women are using alcohol to cope with their stress and this method of

coping creates stress that is far more overwhelming and furthermore, enduring. A woman may drink to

alleviate tension around feelings of sexual dysfunction, especially when she has a history of sexual

abuse. In fact, sexual dysfunction is a result of alcoholism in women. And, women who are drinking

are more at risk for sexual assault and/or rape. Women drink because they feel isolation in their

primary relationships with mates, lovers or children. As a result of their drinking these relationships

are damaged, troubled or destroyed. They are shut off, shut away, abandoned by those they love. This

brings feelings of shame. Depression increases. Then the drinking increases to soothe the pain, and the

spiral continues... (Van der Walde et al, 2002).

Schukit cites that the various factors which may influence the abuse and use of alcohol are

many and varied including societal factors such as age of onset of use and the level of use and

acceptance of drinking of one's peers. Parental elements to be considered are alcohol use/abuse,

conflict, parental warmth and commitment and stability of the home environment. This of course can

be affected by differences in socio-economic status. The stress and individual encounters and their

skills in dealing with this stress are factors to be considered in factoring the risk of abuse of alcohol as

well as the availability of support, connection, concern and care. An individual's feelings of self-worth

and self-efficacy determines how likely they are to respond to grief, sadness and anxiety by turning to

alcohol. These are all very important factors to consider when looking at the abuse of alcohol by

women. Factoring into this problem are genetic factors putting women at risk as well as their innate

levels of impulsivity and disinhibition. Schuckit also highlights the issue that some individuals
expeience intense effects from alcohol than others, especially as the amounts increase. Schukit notes

this in Native Americans and thinks that this particular effect may be genetic (Schukit, 2006).

Alcoholism is an issue for women across barriers of race and socio-economic variables. As

much as the trauma and stress of the lower socio-ecinomic classes is an attiributable cause for

alcoholism in women, so is the stress and expectation in the lives of middle to upper class women who

have to be mother, wife, and breadwinner. Alcoholism is seen in women of intact families and those

where the mother is the sole source of support. But, it is a recognized fact that a family history of

alcoholism and/or trauma puts women at higher risk of becoming alcoholic.

Skulkit, in his text, Drug and Alcohol Abuse: A Clinical Guide to Diagnosis and Treatment

states that lower rates of alcoholism are found among Asians and Jews while higher rates are found in

North American Indians and Eskimos. Skulkit did not find evidence to state whether these differences

were due to societal factorys or to genetic influences (Skulkit, 2006). He does refer to biological

deficiencies in acedtaldegyde (involved in the metabolism of alcohol) in its mitochondrail form that is

noted to be present in both Asian men and women. This deficeiy leads to higher rates of facial flushing

when Asians drink alcohol which could lead to the lower lower rates of alcoholism. Also of note is that

women are noted to have less of the enzyme, alcohol dehydrogenase (ADH)which would lead to higher

blood alcohol counts (BAC's) when women, in general, drink as less alcohol is being metabolized as it

passes through the body. When something increases the BAC, people feel the effects of alcohol

quicker thus lowering the tendency to risk drinking more. This more intense response to alcohol is

noted in African American and Jewish populations which both tend to have a lower rate of disorders

involving alcohol (Skulkit, 2006).

Women growing up in the circumstances of trauma and abuse have well learned habits of denying their

own feelings and needs. They have also, often see the modeling of self-medicating with alcohol.

These women, statistically find themselves partnering with men who are alcohol or drug addicted.
These men often abuse their female partners physically, emotionally, verbally, and/or sexually causing

the woman's self worth to plummet even lower and forcing her to hide these terrible secrets from those

who care for her. She finds herself isolated and alone. Her hopelessness and powerlessness increases

(Van der Walde et al., 2002). Women growing up in chaos and despair often have no skills with which

to cope with all of the abuse now being visited on them. They, now turn to alcohol. It is what they

have known.

substances and client impact

assessment
treatment
challenges to treatment

The topic of addiction, especially drug and alcohol addiction and women is one of stigma and

denial. Women have a lot to loose and they have always known this. The bottom line for women and

addiction is that they can loose their children, their families and the respect of the community.

Addiction in women is a place reserved for shame and, therefore, denial. The reason why women do

not confront their addiction is this denial. The stakes are so high that a women knows to admit

addiction is to risk loosing --- everything. Stephanie Covington, in her 2000 article outlining her

treatment program for recovering women remarks, “the issue of women's addictions is not new, but

until recently it has been characterized by silence” (pg. 99). Women's problems with addiction and

abuse have been historically invisible. Women were not allowed to be seen drinking of television until

the fifties. When E.M. Jellinek did his research about addicion and recovery to form what is now

known as the Jenninek Curve, the responses he got from women regarding their recovery was so

different from the information recived from the male respondents that Jellinek threw the data recived

from women out. Thus, what Covington refers to as the two “cornerstones of alcohol treatment

programs” AA and the Jellinek curve, were based entirely on data received solely from men (pg. 100).

Covington, basing her treatment on the unique needs of women, directs her program, Helping Women

Recover, toward the formation of mutual, empathic relationships between the women in treatent as well

as those who are treating them. These relationships, it is Covington's theory will impart joy ,

empowerment, self-knowledge, self-worth and an on-going desire for connection.

Developmentally, women and men are disimilar in the most fundamental of ways. Men strive

to reach independence. Women strive for connection. Women feel the best about themselves when

they are in conection with others. Covington refers to The Stone Center at Wellsley College's

Relational Model which is based on this theory of connection stating that women need connections that

are “mutual, empathic, creative, energy-releasing and empowering” (Covington, 2000, pg. 104). The
Stone Center's Model states that problems with women, and addictions is indeed one of these problems,

comes when these connections are broken. The break can be within any of the systems, family, work,

or the society as a whole.

Covington states that this need for relationship, more specifically with a man, may be at the root

of a woman's initiation to addiction, the reason for her continued use of substances, and ultimaltly the

numbing addictive solace she seeks when her relationship fails. seeking from may have begun,

contributed to

counter-transference