Birth-Related Defects in the Alcoholic Family System

September 11, 2021
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The topic of this article concerns defects in the alcoholic family system that are caused by the birth of a well baby. This article is not about defects found in a newborn.

As we consider the topic of defects in the family system, for the purposes of this article, let’s consider the family system as one whole solid object.

Sometimes the idea of a planned child is that the arrival of the new family member will repair the alcoholic home.

But we know that the birth of a newborn is a stressor for any family system – alcoholic or not. And we know that in some families the arrival of and ongoing presence of a newborn degrades the function or structure of the family system, or both.

I would like to suggest that the stress brought by the newborn’s arrival might finally bring the pressure necessary to create a fundamental crack or break (a basic fault) in the structure of the alcoholic family system. This can be thought of as creating a new seismic fissure or fault in the totality (or whole) of the family system.

This stress in a home with active alcoholism or a home without sufficient recovery stability could cause a fracture in the basic structure of the family system. And that could leave the family system forever weakened and unsafe for others.

A metaphor for the family system

One metaphor or image commonly used to capture the idea of a family system is that of a mobile, with each part of the mobile representing a different member of the family. And showing the mobile as out of balance is the way a problem in one of the people, or in the system, is shown.

But for this concept the image would not be that of a mobile. Rather, the image is that of an entire solid granite continental shelf a few miles thick. And the problem being shown is represented as a deep break – a new fault. And the break is caused by a new pressure (such as a new birth) – that would normally be thought of as both normal and good.

Extending the metaphor or image of a one-piece solid geologic structure, we should recognize at least two possible problems other than a new deep break exist. The first is that within some families the added stressor would simply make the defects that already existed in the system visible for perhaps the first time. And in other family systems the added stressor would simply make an existing break larger.

Questions include:

  • Why does the topic of “birth defects” seem to always and only pertain to defects in the person of the newborn infant? And why do we have such a limited perspective from which to view the situation?
  • Can our thinking also pertain to new malformations in the family system as a whole?
  • What newly emerging defects of the family system threaten the newborn’s health and well-being?  And for how long?
  • In our clinical work do we examine the integrity and stability of the family system?
  • Do we help the family system accommodate the positive pressures of its existing members, new members, returning members, members shifting into abstinence, and members shifting into recovery?

From ACES to Recovery Capital

This causes me to wonder if we can apply the list of Adverse Childhood Experiences Survey (“ACES”) in a positive way. Such an effort could help us reverse the concept of ACES and identify the features of a healthy-enough recovery community at various social levels, starting with the family system.

What is good enough “parenting”?

  • For the alcoholic home to aspire to?
  • For the abstinent home to aspire to?
  • For the recovering family to aspire to?
  • For the recovery community to aspire to?


If our babies break us, are we a “healing forest”? Or are we only looking at the trees?

To help anchor these concepts and areas of attention we could coin new terms.

  1. One term would be for the problems in the family system caused by the arrival of a newborn. Perhaps for this phenomenon we could coin the term “Birth-related family system defect”.
  2. And we could coin a term for the permanent damage in the actively addicted family system, or the newly abstinent but not recovering family system, caused by the pressures brought by the birth of a newborn. Perhaps that term could be “Fetal recovery syndrome”, given it is the new life present in the new person of the infant that in some cases seemingly deforms the family.

Can we improve our systems of care for chronic, severe, and complex substance use disorders to include evaluation, positive change, and on-going recovery support of the entirety of the family system until the critical threshold of structural instability is resolved?

Suggested Reading

Balint, M. (1969). The Basic Fault: Therapeutic Aspects of Regression. Northwestern University Press.

Coon, B. WHERE is Addiction? July 8, 2021. Recovery Review.

Coon, B. We All Need to Learn “Prevention”. August 13, 2021. Recovery Review.

Herzog, J. I. & Schmahi, C. (2018). Adverse Childhood Experiences and the Consequences on Neurobiological, Psychosocial, and Somatic Conditions Across the Lifespan. Frontiers in Psychology.  doi: 10.3389/fpsyt.2018.00420

Swedish Agency for Health Technology Assessment and Assessment of Social Services. (2016). Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Spectrum Disorders (FASD) – conditions and interventions.

Touloumakos, A. K. & Barrable, A. (2020). Adverse Childhood Experiences: The Protective and Therapeutic Potential of Nature. Frontiers In Psychology. doi: 10.3389/fpsyg.2020.597935

White, W. (2011). Unraveling the mystery of personal and family recovery. An interview with Stephanie Brown, PhD.

Winnicott, D. (1974). Fear of Breakdown. International Review of Psycho-Analysis. 1(1-2): 103-107.

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