Adult Children of Alcoholic or Abusive Parents (ACOA)

One of the areas of therapy I find tricky is when I have to parse out the difference between responsibility and blame, or explanation and excuse.  This is very clear when I am talking to clients about the after-effects of their growing up in a household where the parent(s) were either abusive, alcoholic or otherwise addicted.

For example, one of the after-effects of this kind of history on an adult who was a child of an alcoholic, etc, is that they tend to weigh the needs of others as being greater than their own needs.  However, until very recently that was standard socialization for women; to place the needs of her family highest in her life.  Either of these conditions may be the reason why a woman can’t or won’t make meeting her own needs a priority.  These are explanations.  Now, if a woman continues to ignore her own needs, citing one of the earlier conditions, then that becomes an excuse.

Similarly, a man might tell me that his father died when he was young and he had to go to work to help support his family. He blames his history as the reason why he refuses to work today; he claims he is “making up for a lost childhood”.  He avoids taking responsibility for his life today by blaming his history.

The other side of that coin is the person who is a compulsive worker, afraid to slow down or stop, always anxious about whether or not his/her work is good enough, always striving for perfection.  These approval seekers are vulnerable to getting trapped in abusive or exploitive relationships because they believe the problems in the relationship are their fault and they just have to try harder to make the relationship work.  They take too much responsibility for the problems in their relationships and fail to set appropriate boundaries with their partners.

There are many after-effects from living with an abusive person; fear of authority, being a caretaker or victim, low self-esteem or grandiosity, feeling separate or different from others, difficulties with appropriate levels of emotions, getting involved with abusive persons as an adult, and many other issues.  To get a fuller list of ACOA characteristics, go to: or

If you decide you have been adversely effected as a child in this way, there is a large network of free peer-led groups devoted to healing from these experiences.