IJFIRH - 2024, Volume - II, Issue - IV [October to December 2024]

e-ISSN No- 3048-6270

Published by Homoeopathic Chronicles

HOMOEOPATHIC MANAGEMENT OF ADOLESCENTS HAVING ALCOHOLIC FATHERS BYUNDERSTANDING THEIR ADAPTIVE MECHANISMS

Madhuri Vasant Koli 1

1 PhD Homoeopathy psychiatry (scholar), MD Homoeopathy Psychiatry, Consulting Homoeopath at- Mukta Homoeopathy Clinic, Nerul East, Navi Mumbai- 400706, Maharashtra

Article Received: 18 September 2024 - Accepted: 26 October 2024 - Article published online: 30 December 2024 

DOI: https://doi.org/10.59939/3048-6270.2024.v2.i4.1

ABSTRACT AND BACKGROUND

The aim of this study was to understand the adaptive mechanisms of adolescents having alcoholic fathers and determining role of these adaptive mechanisms in Homoeopathic management. A prospective observational study was conducted on 30 adolescents of both sexes having alcoholic father. Self- made checklist was applied for evaluating stressors at physical, mental and intellectual level. Stressors observed amongst these adolescents were Anxiety about abusiveness of father in 5(17%), anxiety of conflicts amongst parents in 5(17%), abusiveness of father towards mother in 4(13%), no stressor in 4(13%), neglected feeling in 3(10%), embarrassment in 2(7%), and divorce in 1(3%). Most of the adolescents did not show any physical disturbances because of alcoholic fathers. Decreased concentration in studies in 12(40%), loss of interest in studies 2(7%), no affect in 16(53%) Positive adaptation was observed in 15(50%) adolescents & only 2(7%) had negative adaptation. Suppression in 12(40%), escapism along with suppression in 6(20%), escapism in 3(10%), rationalization in 3(10%), sublimation in 2(7%), acting out, Displacement, Repression and Suppression in each 1(3%). Homoeopathy similimum indicated was Calcarea group 10(35%), Natrum group 7(23%), Silicea 5(17%), Lycopodium 2(7%), Causticum, Dulcamara, Magnesium, Medorrhinum, Merc Sol & Phosphorus each 1(3%) .

Key words: Adolescents, Alcoholic Father, Stressors, Adaptive Mechanisms, Homeopathic Management, Ancillary Mode of Treatment

INTRODUCTION

“Dear father, you worse than you know,

It’s not monsters that scare me, it’s you,

And you confuse me, in so many levels,

That I can’t even tell you how I feel

And it makes me mad, because nothing

Makes me sadder than you”

-          Anonymous

A short poem which depicts the feeling state of a child who shares his feeling state after seeing his father under influence of alcohol.

Alcohol addiction is an alarming issue in India. Alcohol consumption not only makes the person sick who consumes alcohol, but also his entire family to suffer along with him. The main care taker of the family when consumes alcohol does not remain the same care taker and support the family sees up to with. Under the influence of alcohol many a times they forget humanity and behave in most inhuman way with his family members.

There are many de-addiction centers to treat these alcoholics and medical facilities to treat their illness. Families who have an alcoholic member in their family may seem physically fit but are never mentally healthy. Especially the children staying in such families are the major sufferer. They undergo mental as well as physical stress developed due to parental conflicts, abuse, and financial crisis. They get disturbed not only mentally but also their physical health gets deteriorated. Their academic performance too gets deteriorated due to continuous exposure to stress.

There are three broad classes of coping mechanism that human used to overcome stressful situations.

1.     By eliminating or modifying stressful conditions.

2.     By perceptually controlling the meaning of the stressor.

3.     By keeping emotional consequences in bounds.

These mechanisms reduce conflict and cognitive dissonance during sudden changes in internal and external reality. If such changes in reality are not “distorted” and “denied”, they can result into disabling anxiety and /or depression. Such homoeostatic mental “defenses”, shield us from sudden changes in the lodestars of conflict: impulse (affection and emotion), reality, people (relationships), and social learning (conscience). For semantic consistency the Defensive Function Scale of DSM IV has labeled these involuntary mental mechanisms defenses. These coping mechanisms or defenses can abolish impulse (e.g., by reaction formation), social learning (e.g., by acting out), other people (e.g., by schizoid fantasy), or reality (e.g., by psychotic denial). They can abolish our conscious recognition of the subject (e.g., by projection) or the object of a conflict (e.g., by turning against self) or awareness of the idea (e.g., by repression) or of the affect associated with the idea (e.g., isolation of affect).

  There are many alcoholics in our surrounding who come home in drunken state and then become worst nightmare for their family. This is almost a common state in many of the families and story of millions of children in our country. I could not see his suffering which raised many questions in mind; how these children must be managing themselves in this adverse situation? What must be their ways and means to keep themselves in a much manageable state? What must be motivating them to keep doing day to day activity without any disturbances?  What emotional impact this alcoholic father must be leaving on their tender mind?  What will be the role of Homoeopathy in entire scenario?  What will the therapeutic role of Homoeopathic intervention? Will it be palliative or curative treatment for them? Up to what extent the counselling will help these children? The concept of doctrine of signature helps us to identify the similarities amongst the remedies and the disease. None of the study has ever been conducted to understand the adaptation doctrine of signature of remedies and the human personality. Therapeutic problem definition is done along with problem resolution is formulated.

  “It is not the strongest of the species that survives or the most intelligent that survives. It is the one that is most adaptable to change” – Charles Darwin (1809 - 1882)

         Hence the study deals with understanding how and what adaptive mechanism used by the adolescent age group children to sustain the stress faced due to father ‘s alcoholism. This adaptive mechanism to be understood in detail and utilizing these adaptive mechanisms to understand the homoeopathic similimum remedy. 

Methodology and Materials:

Study Design: Prospective case series method.

Sample: 30 adolescents (17 males, 13 females), ages 12-18, with alcoholic fathers.

Selection Criteria:

Inclusion: Adolescents with confirmed alcoholic fathers.

Exclusion: Incomplete or unavailable data.

Data Collection Tools:

Standardized Case Record (SCR) of Homeopathy .

RESULTS AND OUTCOME

1)      STRESSORS OF ADOLESCENT DUE TO FATHERS ALCOHOLISM

Fig: 1.0- TYPES OF STRESSORS IDENTIFIED IN ADOLESCENTS

5 (17%) adolescents have stressor identified as abusive behavior of father towards them, anticipatory anxiety of being abused by father 5(17%), also the interpersonal conflicts amongst parents due to father’s alcoholism 5(17%) as equally contributed stressor. 4 (13%) of adolescents had stressor of abusive behavior of father towards mother. 4 (13%) of them did not face any stressor due to alcoholism of father. The other stressors observed were neglected feeling by the parents amongst 3 (10%) of them and other were embarrassment feeling observed in 2 (7%), and divorce of parents in 1 (3%) of adolescents.

2)      REACTION OF ADOLESCENT TO ALCOHOLISM OF FATHER

Fig. 2.0 – REACTION TO STRESSOR 

Amongst stressors produced in adolescents, fear of father was prominent factor in 9 cases (30%) Anger with desire to beat father in 3 adolescents (10%) and progressing towards hatred of father is the second prominent response. Total 8 adolescents (27%) have shown anger towards father, 3 adolescents (10%) had desire to hit father with anger. On the other hand, 3 of them (10%) had no any effect of alcoholism of father on them. 1 (3%) consumed alcohol.

3)      TYPES OF ADATIVE MECHANISMS OBSERVED

Fig.3.0 – ADAPTIVE MECHANISM IDENTIFIED

Suppression has been the most common adaptive behavior use by adolescents i.e. 12 (40%) adolescents. Escapism along with suppression was also observed in 6 (20%) adolescents to be the adaptive mechanism used under stressful situation by the adolescent. Only Escapism was seen in 3 (10%) of adolescents, the other adaptive mechanisms observed are Rationalization in 3 (10 %), Sublimation amongst 2 (7%).

Acting out, Displacement and Suppression, Repression and Suppression and Sublimation in 1 (3%) each was observed.

4)      REMEDY

Fig 4.0 – INDICATED REMDIES

The maximum indicated remedy has been from Calcarea group 10 (35%), Natrum group 7 (23%), Silica 5 (17%), Lycopodium 2 (7%), Causticum, Dulcamara, Magnesium, Medorrhinum, Merc Sol & Phosphorus 1 (3%) each out of 30 adolescents.

DISCUSSION

The topic for study is “HOMOEOPATHIC MANAGEMENT OF ADOLESCENTS HAVING ALCOHOLIC FATHERS BY UNDERSTANDING THEIR ADAPTIVE MECHANISMS” 30 cases of adolescents belonging to age group 12-18 years from various OPDs and adolescents of alcoholic patients admitted in IPD have been studied. The stresses of various types faced by these adolescents at the level of mental, physical and intellectual affection has been studied.

The study included 30 adolescents out of which 17 are male and 13 are females. More males were the sufferer than females. Adolescents suffering from stressors due to alcoholic father were from age group of 12 yrs., 43% (13 cases) where they were in the high peak of development; mental as well as physical. This found to be true and seen in study by Chassin, Curran, Hussong & Colder, et. al. 1996 and the development of mental health problems in adolescence by Ohannessian et al., 2004. After screening and obtaining preliminary data, a checklist was filled as to identify the stressors faced at the level of mental, physical & intellectual level. As the age advances the tolerance and pattern of adaptation develops.

Stressors faced by the adolescents mainly due to father’s alcoholism and parental conflicts. Also includes abusive behaviour of father towards child 5 (17% cases) as well as anxiety of being abused verbally or physically in 5 (17%) cases. Though there was no such episode just mere hearing from other kids was observed in 5 cases (17%) each due to the general understanding of effect of alcoholism of father in the family.  Other stressors faced by the children were the abusive behaviour of father towards mother in 4 (13%) cases. Because of mother being the only support structure. Some of the adolescents 2 (7%) cases felt embarrassed because of alcoholism of father (case 1 & 7).  4 cases (13%) of the adolescents did not feel any stress, mainly because it did not bring any change in Father’s Day to day behaviour towards the child or any other family member. The duration of consumption of alcohol is more than 20 yrs. The study done by (West & Prinz, 1987), (Chassin, Barrera, & Montgomery, 1997; Chassin, Pitts, DeLucia,&Todd, 1999; El-Sheikh & Buckhalt, 2003; Harter,2000; Puttler, Zucker, Fitzgerald, & Bingham, 1998),( Brook, Tseng, & Cohen, 1996; Colder & Chassin, 1997; Eiden, Edwards, & Leonard, 2004; Giancola, Moss, Martin, Kirisci, & Tarter, 1996; Peterson & Pihl, 1990) did not mention the details of stressors faced by the adolescents and their reaction to it. There were various emotional reactive patterns observed in adolescents due to alcoholism of father.

Similar observation is seen where the child sees father in alcoholic and abusive state at very young age mostly right from the age the starts understanding the reality of environment. Hence, we see that the child fails to develop the trust over his or her father and ultimately there is stress built up in the father child relationship which continues till adolescent age too. We could understand that, fear of father as prominent factor in 9 cases (30%) have come up as response to father’s alcoholism. Anger with desire to beat father in 3 (10%) adolescents and progressing towards hatred of father is the second prominent response. Total 8 adolescents (27%) have shown anger towards father, 3 adolescents (10%) had desire to hit father with. On the other hand 3 of them (10%) had no any effect of alcoholism of father on them. 1 (3%) consumed alcohol as per the tradition of consumption of alcohol in the family. 1 (3%); of the adolescent was abusive towards mother and grandmother in similar way as father was towards the both of them. 1 (3%) of the adolescent hated his mother as he blamed mother for his father’s alcoholism and divorce of parents.

The emotional response includes an action tendency-that is an urge to respond to the encounter in a particular way to attack in anger, cry in sadness, flee or avoid in anxiety, and so on. Nevertheless, at all but the most extreme levels of emotional arousal, people have the ability to suppress the action tendency and select from a wide array of coping options; this illustrates the flexibility of the emotion process. It is mainly found that suppression of emotions as the maximum adapted mechanism in adolescents 12 out of 30 (40%) to the stressors faced due to alcoholism of father. Escapism along with suppression was the second most adapted mechanism observed in 6 (20 %) adolescents. Escapism was seen in 3 (10%) of adolescents, the other adaptive mechanisms observed are rationalization in 3 (10 %), sublimation amongst 2 (7%). Acting out, displacement and suppression, repression and suppression and sublimation in 1 (3%) each was observed.

There were positive adaptive methods used by these adolescents which were observed during the study. The most commonly used positive adaptive mechanism is avoiding the situation and staying away from the stressful situation which was observed in 15 (50%) adolescents. 8 (27%) out of 30 adolescents did not have any specific positive adaptive mechanism in the stressful situation. Other positive adaptation observed was calming father when angry in case no 8, indulging in other activity in case no 4, not getting stressed, not getting involved was observed in 1 (3%) of adolescents. 2 (7%) did not get involved in parental conflicts.

  There are as such no definite negative adaptive mechanisms specifically observed. 9 (30%) & 7 (23%) out of 30 adolescents did not have any specific negative adaptation to the stressful situation. 2 (7%) of the adolescents had distant themselves from father by avoiding communication with father & developing excessive anxiety on seeing father in drunken state.

  Adolescents’ patients presented with somatic complaints brought on from alcoholism of father. That was mainly due to abusive behaviour of father which produces fear, anger, and hatred such emotions towards father. 3 (10%) cases of adolescents have recurrent upper respiratory tract infection, 2 (7%) cases of the adolescents have complaints of abdominal pain & chest pain. 16 (54%) cases of the adolescents did not have any somatic complaints due to stressors.

LIMITATIONS

1)  Equality in selection of sample on basis of gender lacked hence assessment on basis of gender could not be done, as sample size was small of 30 cases.

2)  Due to lack of follow ups the remedy outcome could not be assessed accurately.

3)  The academic progress could not be assessed due to in- consistence of follow up.

CONCLUSION

As compared to older aged adolescents the younger aged adolescents (12 years – 13 adolescents) are more to be affected by alcoholism of father.  The commonest found reaction due to alcoholism of father is fear towards father the second common been anger towards and neglected feeling from father. The commonest used adaptive mechanism is suppression of emotions and the second most is to escape from the situation. The other adaptive mechanisms used are Acting Out, Displacement, Rationalization, Repression, and Sublimation, which was found in few cases.

These adaptive mechanisms were used to understand the homoeopathic similimum prescription. Calcarea group remedies were prescribed to 10 adolescents and Natrum group was prescribed to 7 adolescents after understanding in detail their adaptive mechanisms. Adolescents who mainly had fear as their reaction and avoided the situation due to fear i.e. escapism were prescribed remedy from Calcarea group. Adolescents who had anger towards father and had anger towards father and who had suppression of their emotions as their adaptation were prescribed remedies from Natrum group. Parental counselling was given to required group of parents; De- addiction treatment was suggested and given to few of the parents.

Clinical use and future research:

Homoeopathy is second most widely used system of treatment according to WHO. Homoeopathy has scope beyond physical mode of treatment. Lack of evidence-based research has led to doubting on mode to treatment via Homeopathy. Addiction is major issue in country like India, where prevalence of joint family still persists. Children are still dependent on parents beyond adult age hood, hence disrupted one family member disrupts entire family and their life and living which may lead to psychological, physical or stress related illnesses.  Many of illnesses can be prevented to reach at diagnostic level, if homoeopathy medicines are prescribed on basis of similimum. This research was an attempt to this method of management. Today many of one of such parental alcohol related disorder. Homoeopathy has potential in managing these disorders effectively. Hence more and more of such studies should be conducted, to understand effectiveness of Homeopathy with evidence. Use of various psychological tools to add to its evidence-based management can be achieved.

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AKNOWLEGEMENT:

I would like thank DR. M.L. Dhawale Memorial Homoeopathic Institute, and Rural Homeopathic Hospital Palghar, for providing me with a proper set up and provisions to complete my study. I am extremely indebted to my guide Dr. Sunita B. Nikumbh M.D.(HOM), Reader to psychiatry department, DR. M.L. Dhawale Memorial Homoeopathic Institute, and Rural Homeopathic Hospital Palghar, who has supported me through every step in my dissertation and guided me with her expertise. Without her support and guidance, I would have never been able to accomplish my study.