The Legacy of Untreated Secondhand Drinking-Related ACEs


I am the child of an alcoholic. My mom didn’t stop drinking until age 79. She died at 84. There was no warning, no lingering illness. She died two days after an unsuccessful emergency surgery. But we had five years during which she did not drink, after forty-five years during which she did.

You see, my mom knew she had a drinking problem. So did we, the rest of her family. There were times when she fought mightily to stop or control it. There were times when the rest of us fought mightily to help her. She even succeeded in cutting back or not drinking for periods of time, which convinced her and us that she really wasn’t an alcoholic(1) . None of us knew alcoholism(1) was a developmental brain disease; a chronic, often relapsing brain disease. None of us knew one of the key risk factors for developing the disease is childhood trauma. None of her primary care doctors who saw her over the four+ decades her disease marched on ever diagnosed it.

Ironically, my mom was also a 17-year cancer survivor when she died. She knew to do (and did) self-breast exams. She found a lump and immediately contacted her doctor; her doctor immediately ordered a biopsy; and she was diagnosed with breast cancer in 2000. She had a mastectomy, went through chemotherapy, lost her hair, and showed such courage and grace in her battle to recover. (If you’ve ever witnessed someone recovering from cancer, you know what I mean by “battle.”)

But cancer was a disease people and their doctors understood. Symptoms and having the disease were openly talked about and medical protocols were routine. There was no denial, secrecy, lying or self-judgment.

This was not the case with my mom’s other disease – alcoholism.

It wasn’t until my mom’s third alcohol-related collapse and ambulance ride to the ER within a one-week period in the summer of 2011 that she was finally diagnosed with acute alcoholism. The ER doctor said she was too sick to go home and referred her to a skilled nursing facility.

In her first weeks at the facility, she couldn’t walk but a few shuffling steps with someone on both sides holding her up. She had difficultly recognizing her family, didn’t know how to sequence washing her hands or going to the bathroom without help, and ate like a toddler – mostly shoveling food into her mouth with her hands – the idea of using a napkin and utensils didn’t register.

Her treatment included intensive occupational therapy, physical therapy, speech therapy, and eating nutrient rich foods and vitamins. By the end of her stay, as her clarity returned, she felt great shame, guilt, and remorse. She wanted desperately to go home and promised never to drink again. She never did.

As you can imagine, there are many directions this story could take at this point, but I’m going to focus on…

The Legacy of Untreated Secondhand Drinking-Related ACEs

During the last years of her life, my mom and I talked a great deal about the work I’d been doing since 2003. She’d known the gist of it. I had offered my expertise and help over the years and couched it in terms of the other alcohol misusers(2) in my life’s experiences and my own secondhand drinking experiences and eating disorders. She’d get uncomfortable and gloss over my giving a presentation or completing a book on an addiction-related topic with a vague, “That’s nice dear. I’m happy for you.” There were times after a particularly bad bout or a disastrous consequence of drinking that she’d express a willingness to get help, but she never wanted to go to rehab, nor back to AA, something she’d tried early on.

But after she stopped drinking in 2011 and had some months of clarity, she didn’t cut me off as I shared a new talk or blog post topic.

She eventually started asking questions and was especially taken with the ACE Study and adverse childhood experiences. As we talked over time, she came to understand and appreciate that adverse childhood experiences cause toxic stress and that toxic stress can actually change a child’s brain architecture, negatively affecting their lifetime physical and emotional health. She loved my concept of secondhand drinking:

Secondhand Drinking (SHD) refers to the negative impacts of a person’s drinking behaviors on others. Drinking behaviors include verbal, physical, emotional abuse; neglect; blackouts; unplanned/unwanted sex, sexual assault; breaking promises to stop or cut down; shaming, blaming, denying; unpredictable behaviors; and driving while impaired, to name a few. Drinking behaviors are caused by a number of drinking patterns, including: binge drinking, heavy social drinking, alcohol abuse, and alcoholism. People engaging in these drinking patterns are referred to as alcohol misusers. The negative impacts a person coping with SHD experiences are related to toxic stress.

But it was the connection between ACEs and SHD and how they set up the key risk factors for developing addiction (of which alcoholism is one) - see image below - that rocked her world the way it had rocked mine. It was this connection and finally understanding that alcoholism (addiction) is a brain disease that set her free. She didn’t “choose” to become an alcoholic just as she didn’t “choose” to have breast cancer; nor was she weak-willed, immoral, uncaring or any of the other adjectives used to label persons with this particular disease.

The Legacy: Blindly Passing SHD-related ACEs to the Next Generation

During our conversations, mom identified herself as having five ACEs and that her own mom (my grandmother) had a drinking problem. She talked about some of her mom’s drinking behaviors.

My mom and I discussed how I had four ACEs, and my daughters both had four. We identified similar ACE history patterns in some of my other alcohol misusing loved ones(2). One had five, another three, and a third six, for example.

And all of us had long-term exposure to secondhand drinking. To be clear – not all ACEs are related to SHD, of course. My mom had two and I had one of those, as well.

Mom and I talked about my realization that I’d blindly participated in passing along the consequences of my own untreated SHD-related ACEs to my daughters the same way my mom had blindly passed hers to me. And these consequences were not limited to developing alcoholism or an alcohol use disorder. They were the consequences of insecurity, anxiety, fear, anger, self-judgement, unclear boundaries, accommodating the unacceptable, constant worry, and the other physical, emotional and quality-of-life consequences of toxic stress. It was this shocking insight that moved me to treat my untreated SHD-related ACEs and help my daughters treat theirs.

Bottom line is these discoveries helped my mom finally forgive herself the way I had forgiven her years ago. Not the kind of forgiveness that excuses trauma-causing behaviors, rather the kind of forgiveness that lets go of wishing for a different outcome. It is the kind of forgiveness that recognizes we were all doing the best we could with what we knew at the time.

Breaking the Cycles – Changing the Conversations

To close this post I want to share one of my mom’s greatest gifts to breaking the cycles of untreated SHD-related ACEs and untreated ACEs in general. It happened during one of our phone calls.

She said to me, with deep emotion, “Lisa – please – please use my story – our story – to help others.”

And so I am.

There wasn’t enough time for my mom to heal from her ACEs, nor for she and I to develop the mother/daughter relationship I now have with my two daughters. Our experience is so different because of the healing work the three of us were able to do to change the legacy.

But my mom started her process by breaking the denial, secrecy, lies, and self-judgment about her alcoholism and its root causes. And it is the four of us together – my mom, myself, and my two daughters – who have now changed the legacy in our family. As such, we pass forward not lies but the truth, not self-judgment but self-compassion, not secrecy but openness, not denial but seeking awareness. Something I didn’t even understand let alone could have imagined possible just fourteen years ago.

Lisa Frederiksen
Author | Speaker | Trainer | Consultant
Founder of and SHD Prevention

Author of 11 books, including: If You Loved Me, You'd Stop!, Loved One in Treatment? Now What!, and Quick Guide to Secondhand Drinking: the Phenomenon That Affects Millions