What is an ACOA?

 By Mary Elizabeth O Brien, Applied Psychology, University College Cork

ACOA or Adult Child of an Alcoholic is a term that is sometimes used to describe someone who grew up with parental alcohol misuse.

What is it like to be raised by parent who misuses alcohol?

  • When living with a parent who misuses alcohol, family members may try to behave like a normal family in an attempt to hide the problem and maintain the status quo despite the disruptive behaviour which can be very emotionally upsetting and unpredicatable. This can result in huge costs to the family unit and members which are financial, social, psychological, physical and relational.
  • Children can respond to their chaotic environment by repressing their normal and natural feelings of sadness, confusion and anger which feelings can resurface later on in life.
  • A tense atmosphere including an intense emotional environment is often present which can result in the development of anxious and ambivalent attachment patterns in children.
  • Communication outside the home can become limited in an effort to hide the family secrets. This can stunt development of social/communication skills.
  • The stigma and shame the family members experience may also prevent access to help and support.
  • The quality of parenting is likely to be compropmised or diminished in parents who misuse alcohol. Therefore, bonding opportunities are lost and responsiveness minimised. Ineffective and inconsistent parenting strategies can include resorting to an authoritative parenting style such as, ‘do as I say and not as I do’ method of parenting.
  • Children of parents who misuse alcohol often have to grow up too quickly and may assume responsibilities that they should not have had to; a trait they are likely to carry with them into adulthood.
  • It has been reported that 14% of adults who experienced parental alcohol misuse as children felt afraid or unsafe; 14% often witnessed conflict between parents, while 11% said they often had to take responsibility for a sibling, because of parents’ drinking.

Impacts in Adulthood

Key areas of development that are often affected include attachment, self-regulation & stress response. These disrupted developments can manifest themselves in adulthood as:

  • Lacking positive relationships in a developmentally pivotal time of one’s life can considerably impact one’s ability to form healthy relationships later on in life. This is particularly significant when a dysfunctional relationship was present in lieu of a stable one. Adults who grew up with parental alcohol misuse may not be as equipped as others to discern positive/ negative traits in others and subsequently may find themselves in unhealthy relationships.
  • Adults who grew up with parental alcohol misuse often had to deny their feelings of sadness, anger and fear in order to survive. These emotions can surface later on in life with little to no understanding attached to them and can be a source of anxiety.
  • Research suggests that adults who grew up with parental alcohol misuse often didn’t have their emotional needs met as children. Consequently, in adulthood, they may have a tendency to either withdraw and isolate themselves or to compete for whatever love and attention is available to compensate for a lack of affection attained during childhood.
  • Adults who grew up with parental alcohol misuse may adopt unhelpful coping mechanisms as adults to try and deal with their inner experience of chaos. These can include shutting down their own feelings, denying that there is a problem, rationalizing, intellectualizing, over-controlling, withdrawing, acting out or self-medicating. [i]
  • Adults who grew up with parental alcohol misuse may find it difficult to be honest with themselves as they spent much of their life hiding the truth from themselves, their family and others.
  • Romantic relationships can be problematic as a level of dependency and vulnerability presents itself again which can lead to anxiety having been repeatedly let down or rejected in the past.
  • Interpersonal relationships can also prove difficult as adults who grew up with parental alcohol misuse may have difficulty in trusting others.
  • Adults who grew up with parental alcohol misuse may lack the psychological and emotional tools necessary to deal with the negative emotions of themselves and others; they may navigate life with a learned sense of helplessness, powerlessness, and are consequently more likely to fall victim to their environment.
  • While adults who grew up with parental alcohol misuse are 3-4 times more likely to become alcohol dependent themselves, it often has given them an acute awareness of alcohol misuse and the vast majority of adults who grew up with parental alcohol misuse do not become problem drinkers being more aware of the impacts on others.
  • Some adults who grew up with parental alcohol misuse may engage in risk taking behaviour in an effort to feel something rather than emotional numbness.[ii] This can sometimes put them at risk of danger.
  • Adults who grew up with parental alcohol misuse often feel a huge depth of grief for the loss of their childhoods and relationship with the problem drinking parent.


What to do if the above resonates with you?

Seeing yourself in any of the above descriptions should not be cause for concern. Identifying issues is the first step to addressing them. Adults who grew up with parental alcohol misuse, though they are often unaware of it, have huge strengths and skills which they acquired in order to survive childhood adversity. They are often very adaptive, resourceful, and have every chance of recovering from any unhelpful patterns of behaviour they may have learned. If you feel like you have been affected by any of the things mentioned above, know that you can access supports such as talking therapies.


What can help?

  • Therapy is an effective way to talk about and process pain and grief. It is also a very effective treatment for depression and anxiety, two conditions which are commonly experienced by adults who grew up with parental alcohol misuse. It can provide the opportunity to learn about the nature of addiction and to grasp a deeper understanding of your childhood. You will also become more aware of how your up-bringing shaped your adult life. Overall, therapy can help to reduce shame, improve self-esteem and provide tools for healthier relationships.
  • Peer groups can also be helpful for adults who grew up with parental alcohol misuse as it presents an opportunity to share their struggles with people who understand and to learn coping mechanisms from those in similar situations.


Who can provide assistance?

  • Talking therapies are recognised as the most effective way to manage emotional distress. It is important to access accredited counsellors, psychotherapists or psychologists. Each of these groups have professional bodies that provide details of support in your area.
  • Talking therapies can firstly help us to explore our current difficulties, then explore our past history by connecting our past to our present to enable us make sense of our childhood adversity and its impact. We can learn to challenge internalised beliefs and defences we have had to use to survive and learn new skills to help us regulate our internal and external world.
  • This can in time lead to healing, understanding and post traumatic growth.


Please also see https://alcoholaction.wpengine.com/silent-voices/resources/

[i] Dayton, T. (2004). The set up: Living with addiction.

[ii] Horgan, J. (2011). Parental Substance Misuse: Addressing Its Impact on Children: Key Messages and Recommendations from a Review of the Literature. Stationery Office.