Lisa Frederiksen

What you really need to know when your loved one drinks too much

Lisa Frederiksen is the author of a great new book entitled If YOU LOVED ME, YOU’D STOP!– What you really need to know when your loved one drinks too much

Family Business Experts (FBE) conducted an author interview with Lisa Frederiksen this past week and we are pleased to share the interview with visitors to our web site.

Lisa, when someone Googles the term alcoholism, the results of the search are over 13,700,000 sources of information. With all of the information available, there is still a lot of confusion about definitions and terms associated with alcoholism? So lets start there.

FBE - What is an alcoholic?

Lisa Frederiksen Most people think of drinking as either “normal” or “alcoholic.” What we don’t understand is that there is a whole other “stage” — alcohol abuse (excessive drinking).

Alcohol abuse is the term used to describe the various forms of excessive drinking that cause significant risk, harm and distress to the excessive drinker and to his or her family and friends – risk, harm and distress that equals that which is most often associated with alcoholism.

So, to answer this question, it is helpful to understand the difference between alcohol use, alcohol abuse (excessive drinking) and alcohol dependence (alcoholism).

Alcohol use is also known as “normal” or “moderate drinking.” The NIAAA defines “normal” drinking (alcohol use) as:

no more than 3 drinks in a day AND no more than 7 in a week for women

no more than 4 drinks in a day AND no more than 14 drinks in a week for men

Binge Drinking 4 or more drinks on one occasion for women and 5 or more drinks on one occasion for men is considered binge drinking. Binge drinking is not considered “normal” drinking.

One way people inadvertently drink too much is by not understanding what a standard drink is and so they over-drink without realizing that is what is happening. Drinks served in bars and restaurants, for example, often contain more than one standard drink. So, it’s helpful to know one standard drink in America is defined as 5 ounces of wine OR 12 ounces of beer OR 1.5 ounces (a shot) of 80-proof distilled spirits (scotch, gin, vodka) and then to actually measure it and pour it into a glass to see what it looks like, too.

Alcohol abuse is when a person continues to excessively drink in spite of the problems their drinking is causing. These include driving while intoxicated, DUIs, relationship problems with a spouse, parent, boss, friend or child, suspension from school, arrests, recklessness, unprotected or unwanted sex, and/or absences from work. It is generally during the alcohol abuse stage that loved ones, coworkers and/or friends start to comment about the drinking and what happens when the person drinks. It’s important to understand that all alcoholics go through a period of alcohol abuse. Not all alcohol abusers become alcoholics.

Alcohol dependence (alcoholism) is an addiction, an addiction to alcohol. Addiction is a chronic relapsing brain disease, caused in part by the chemical and structural changes that occur in the brain as a result of the alcohol abuse. The alcoholic (a person with an addiction to alcohol) engages in the same drinking behaviors as the alcohol abuser (DUIs, relationship problems, unwanted sex, etc.), but they also have the disease of addiction. The disease includes the following four symptoms:

Craving–A strong need, or urge, to drink – this craving/need is 3-5 times stronger than our hardwired instincts to eat when hungry – which explains why alcoholics will go to any length (lie, steal, forgo responsibilities) in order to drink

Loss of control–Not being able to stop drinking once drinking has begun

Physical dependence–Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety after stopping drinking

Tolerance–The need to drink greater amounts of alcohol to get “high.”

FBE - How can you tell if someone is an alcoholic?

Lisa Frederiksen While a medical professional should be the one to conduct the assessment and make the determination, you can do it, too, from your perspective, to see where your loved one’s drinking falls.

The World Health Organization (WHO) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) provide well respected assessments.

It is important to understand that you are assessing for your sake - not to get your loved one to “see the light.” But, it does help you to understand what you are dealing with and that can free you to learn more about what you can do about the situation.

In my book I used an assessment developed by the World Health Organization (WHO) called AUDIT (the Alcohol Use Disorders Identification Test)

To complete the assessment, mark the answer that best applies to your perception of your loved one’s drinking. In other words, the “you” is your loved one. [Don’t forget, the “size” of a drink matters. A drink is defined as 5 ounces of wine OR 12 ounces of beer OR 1.5 ounces of 80-proof spirits (vodka, scotch).]

    1. How often do you have a drink containing alcohol?

    (0) Never (1) Monthly or less (2) 2 to 4 times a month (3) 2 to 3 times a week (4) 4 or more times a week

    2. How many drinks containing alcohol do you have on a typical day when you are drinking?

    (0) 1 or 2 (1) 3 or 4 (2) 5 or 6 (3) 7, 8, or 9 (4) 10 or more

    3. How often do you have six or more drinks on one occasion [note: this is known as binge drinking, and in the U.S., binge drinking is five or more drinks on one occasion for men and four or more drinks on one occasion for women]?

    (0) Never (1) Less than monthly (2) Monthly (3) Weekly (4) Daily or almost daily

    4. How often during the last year have you found that you were not able to stop drinking once you had started?

    (0) Never (1) Less than monthly (2) Monthly (3) Weekly (4) Daily or almost daily

    5. How often during the last year have you failed to do what was normally expected from you because of drinking?

    (0) Never (1) Less than monthly (2) Monthly (3) Weekly (4) Daily or almost daily

    6. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session?

    (0) Never (1) Less than monthly (2) Monthly (3) Weekly (4) Daily or almost daily

    7. How often during the last year have you had a feeling of guilt or remorse after drinking?

    (0) Never (1) Less than monthly (2) Monthly (3) Weekly (4) Daily or almost daily

    8. How often during the last year have you been unable to remember what happened the night before because you had been drinking?

    (0) Never (1) Less than monthly (2) Monthly (3) Weekly (4) Daily or almost daily

    9. Have you or someone else been injured as a result of your drinking?

    (0) No (2) Yes, but not in the last year (4) Yes, during the last year

    10. Has a relative or friend or a doctor or another health worker been concerned about your drinking or suggested you cut down?

    (0) No (2) Yes, but not in the last year (4) Yes, during the last year

Now, look at the numbers in the ( ) for each answer you’ve circled and total those numbers. According to AUDIT, total scores between 8 and 19 indicate alcohol abuse (excessive drinking). Total scores 20 and above indicate alcohol dependence (alcoholism). A score of 0-7 indicates drinking at moderate levels. This is also known as “normal” drinking or “alcohol use.”

CAUTION: The AUDIT goes on to say that in the absence of a trained professional conducting this questionnaire (as he or she knows how to ask the question and interpret the answer or dig more deeply for an accurate answer), these guidelines and scoring must be considered tentative – NOT definitive

FBE - Is alcoholism really a disease?

Lisa Frederiksen Yes. New brain imaging technologies (PET, MRI, SPECT) have given neuroscientists and medical professionals tools like never before. They’re now able to see what happens to the live brain of an alcoholic - and what they are showing is significant damage and alterations in the actual structure of the brain. You will learn more about these findings and the disease of alcoholism in my book or through one of my presentations.

FBE - Can alcoholism be cured?

Lisa Frederiksen No. Alcohol dependence (alcoholism) cannot be cured, but it can successfully be treated. There are a number of treatment options, but the absolute key to successful treatment is to eliminate alcohol entirely. Neuroscientists are now able to see how the brain can recover once alcohol use is stopped.

It is critical for family members to understand that for an alcoholic there is absolutely no quantity of alcohol they can drink, EVER, if they want to recover. Not one, not two, not on holidays nor on special occasions, not after ten years of abstinence. Alcoholics cannot drink. Additionally, as long as an alcoholic drinks any amount of alcohol or thinks they can successfully drink at sometime in the future, there is no amount of willpower nor good intentions that can help them avoid the next problematic drinking episode.

FBE - What about alcohol abuse – can it be cured?

Lisa Frederiksen Cure is not the word, but yes, it can be stopped. Because the alcohol abuser has not crossed the invisible line to addiction, that person is able to change their drinking habits (which may include stopping all together or limiting their drinking to fall within safe drinking limits described in the first question).

FBE - How does a family member’s drinking affect a family business?

Lisa Frederiksen - Just by the nature of being a family business, there is a tendency to protect the family and to unite around members of the family because after all, it’s their business and there is a unique bond, simply by being family. Add to this the nature of the denial that is present in all family systems where there is drinking – denial by the alcohol abuser or alcoholic that it’s really that bad or that something else is the reason for getting drunk (e.g.,”I hadn’t eaten all day” or “Everyone was drinking” or “At least he’s not mean when he drinks”), there is a tendency to cover-up or compensate for a drinking family member’s poor work performance or the fall-out from their drinking behaviors.

This has significant impacts on the business – on other employee’s who feel compelled to go along with the cover-up; on professionals (CPAs, attorneys) who work with the business who may rely on agreements made or be delayed in their own performances of work because of the drinking family member’s inability to remember or to follow-through; and on the family itself if there is more than one family member involved in the business.

Additionally, there is the stress of what goes on in the homes of the various family members – even if they aren’t the drinking family member’s home. Everyone carries some sort of stress for either the cover-up, the denial, the work failures, the relational issues, the inappropriate statements or behaviors towards co-workers while drunk…and the list goes on. They take those stresses home with them, which in turn affects how they deal with their loved ones at home.

FBE - What can someone do to help a family member who drinks too much?

Lisa Frederiksen:

Learn as much as you can about the disease of alcoholism and about alcohol abuse and what constitutes normal drinking. HBO, in collaboration with the Robert Wood Johnson Foundation, NIAAA and NIDA, has produced an excellent website and video series about addiction. Here’s the website,

Learn as much as you can about what happens to you (and other family members) by virtue of growing up with or living with an alcoholic or an alcohol abuser. This will help you to become open to ways to make your life more enjoyable whether your loved one stops drinking or not.

Learn to talk openly and honestly about what’s going on and thus stop the denial. It really is “that bad” - whether it’s alcohol abuse or alcohol dependence (alcoholism).

My book offers many suggestions. You’ll find similar information on my blog,

FBE - Why do you think there are so many problems related to alcoholism and the problems it causes?

Lisa Frederiksen - Denial. Shame. Lack of knowledge and understanding.

I think the denial comes into play because of society’s inaccurate view of alcoholism as a shameful lack of willpower. This view drives the alcoholic and his or her loved ones to continue making one Herculean attempt after another to battle the disease - (and long before the disease, the alcohol abuse) - in isolation.

Additionally, society is even more silent on what is happening to the family and friends who love the alcoholic or alcohol abuser (a.k.a. “codependents”) and presumes that if the drinking stops, then all should be well with them, too. This is another gravely destructive assumption. I, myself, had been living with alcoholics and/or alcohol abuse and the family disease of alcoholism for some thirty-five years before I finally admitted, “I need help!

FBE - Who will benefit from reading this book or from one of your presentations?

Lisa Frederiksen - This book or one of my presentations can benefit anyone in all three systems of a family business: the family business owners/managers; family members working in the family business; the professional service providers and the family members at home. Why? Primarily because they’ll better understand the latest brain research on addiction, facts about alcohol abuse and alcoholism not commonly known, as well as the latest brain research and information about what happens (e.g., the coping skills they adopt) to the family members and/or co-workers of the person who is drinking too much.

FBE - What made you write this book?

Lisa Frederiksen It was 35 years before I (the non-alcoholic / alcohol abuser) got help and that was the result of one of my loved ones entering a residential alcohol treatment program. The program had a strong family component, which is how I finally started to come to grips with what had happened to me (the non-alcoholic) and that there were behaviors I’d adopted over the years in order to cope — behaviors that were not helping the alcoholics/alcohol abusers in my life nor the non-alcoholics/alcohol abusers in my family nor myself. It was in coming to grips with my behaviors that I could change my life.

FBE - What do you hope to accomplish by writing and speaking on these subjects?

Lisa Frederiksen I hope to use my experiences and years of research, individual therapy, interviews, family therapy, AlAnon and conversations with others whose lives have been affected by someone’s drinking, to help others so they don’t have to spend decades living with it and slowly eroding the quality of their lives.

To that end, I hope to change (and in some cases, simply start) the conversations surrounding alcohol abuse, alcoholism, underage drinking and codependency, the same way we changed those surrounding cancer, AIDS and smoking.

In the 1950s, for example, the word, “cancer” was not mentioned - it was called “the Big C.” But today, we’re raising millions of dollars to fight it.

In the 1980s, no one wanted to talk about HIV/AIDS, while thousands were dying. Again, that’s not true, today

In the early 1970s, most people smoked cigarettes, drove cars without seat belts, road bicycles without helmets and hadn’t heard of an infant car seat. Yet, new information and talking about these activities convinced millions of Americans to stop smoking cigarettes and outlaw smoking in public places. New information and talking about it led to the passage of laws to require bike helmets until age 18, seat belts for everyone and car seats for children ages 4 and under.

That’s what new information AND talking about it can do and that’s what my book, presentations and blog are all about. Together - openly discussing all of the issues surrounding alcohol abuse and alcoholism WITHOUT shame, guilt and denial - we can break the cycles and bring about similar understanding and change!

FBE - Thanks Lisa and continued success with your book and presentations.

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