Afterword by Sandra Cohen Holmes

Spofford Hall opened in 1980 and closed its doors within ten years at about the same time as many other highly respected and accredited alcoholism residential treatment centers. It is conjectured the closings were insurance-driven; that is, from the insurers' accounting point of view, the expense of covering alcoholism treatment was not cost-effective.

Sandra Cohen-Holmes was hired prior to Spofford Hall opening its doors to create and direct the Family Treatment Program. She hired the personnel, designed each component of the program, and worked to integrate the treatment of family members into the larger population of 100 alcoholics. She trained the staff, many of whom were recovering alcoholics, to understand that family patients were there for themselves, to address their own problems and not there to help their alcoholic. In the Afterword, she describes how she amassed the knowledge and experience to become a key member of Spofford's executive staff.

Sandra: I consider my Spofford experience as actually the most exciting and creative professional work I have done. Reading the Spofford Hall section of Stark Raving Sober brought it all back. Donna's description of the Family Residential Treatment Program is so accurate that I felt as if I were there.

My interest in alcoholism was piqued by a series of experiences. During the early 1970s while placing under-employed and unemployed clients in job training situations, I noted that those who were in recovery from alcoholism did well, but those who were drinking did not. I wanted to understand the reason for the difference. I attended AA meetings and talked with people at a Portsmouth, New Hampshire recovery club. I brought an open mind to the discussions because I had no personal experience with alcoholism. I had a male friend who was a blackout drinker; I worked part time for him. I learned more about alcoholism driving a taxi than in graduate school where alcoholism was never mentioned. At a conference on couples therapy, I had lunch with an alcoholism therapist and a recovering alcoholic. The pieces of the alcoholism puzzle began to fall into place.

My fascination with the effect alcohol has on the mind has lasted my entire care– the way it distorts perception, alters and numbs emotional capacity – especially empathy – and the role of blackouts in making the data of one's behavior unavailable to the drinker, and the crazy-making of those around the drinker. So, too, has the belief that someone with alcoholism is a person first, a unique person with an illness, no two the same, and that alcoholism is never deliberate. It happens and it hurts, and the cost and suffering are immeasurable.

My first work in the field of alcoholism was as an educator for arrested drinking drivers at the Outpatient Alcoholism Clinic (Lawrence, Massachusetts). There I became a therapist counseling alcoholics. I participated in a series of intensive training seminars at the Johnson Institute (now Hazelden) and learned about the impact on families from Sharon Wegsheider Cruse, Vernon Johnson, Claudia Black and others. I implemented more effective treatment for families. In 1979 I left the clinic to have a child. When he was six months old, I read a newspaper ad seeking a Family Treatment Director at Spofford Hall.

I consider myself bilingual: alcoholism is my second language. While I was conducting an intervention, a twelve-year-old boy said, "I didn't know my father had a disease. I thought there was something about me that made him unable to love me." That children and partners take personally the words and actions of those under the influence keeps them stuck, forever analyzing why the drinker drinks and why am I not enough? Like a scene in the movie The Raiders of the Lost Ark, when they are searching for the Lost Ark (or the Holy Grail), leading man Harrison Ford yells, "They're digging in the wrong place!" It doesn't matter why a person drinks. What matters is what happens when they drink and how it affects us.

After 30 years of working in the mental health field, I continue to see an assembly line of pain – people affected, damaged and traumatized by drinking and drinkers. I have to wonder why alcohol-related problems continue to riddle our society. The entire criminal justice system (judges, lawyers, police departments, prisons) and to some extent the medical systems are supported by alcoholism. The liquor industry is the largest lobbyist against the legalization of marijuana. I believe the war on drugs is also digging in the wrong place. Alcoholism, like terrorism, is on our streets and highways maiming and killing innocent people and it's in our homes where small children hide powerless under their beds worrying about their parents and learning too well that their own feelings and needs don't count.

I remember a brave young woman in her early twenties who wanted to confront her father with the impact his alcoholism had on her childhood. By then her father had been sober a few years. Before she could speak her piece, she became frightened and disassociative, regressing to about age ten, cowering in the office chair. Her father saw her terror and said, "If the sober me knew the drinking me, I would have killed me."

For the past twenty-three years, Sandra Cohen-Holmes has been in private practice in Dover, New Hampshire. In addition to treating adults with a broad spectrum of issues including addiction and co-dependency, for fifteen years she taught a four credit forty-five hour college course she designed entitled "Addiction and the Dysfunctional Family" for the College for Lifelong Learning (now Granite College). She has an M.Ed (with emphasis in counseling) from the University of New Hampshire.