Adult Children of Alcoholics (ACoAs): Healing From Childhood Trauma and Learning to Thrive

Growing up with a parent who has an alcohol use disorder, a condition marked by an inability to control alcohol use despite its consequences, can make childhood hard. That stress can continue into adulthood.¹

Some adult children of alcoholics (ACoAs) may develop an alcohol use disorder themselves, while others feel disconnected from the world around them. Others may develop a mental health condition that makes daily life harder.¹

No matter how your childhood affects you over time, understanding your experiences and knowing how to find the right support can help you work through the pain of a childhood affected by alcohol.

Understanding Adult Children of Alcoholics

Adult children of alcoholics (ACoAs) are people who grew up in a home with one or more parents with alcohol use disorder.¹

Some ACoAs enter adulthood without lasting effects. Others continue to feel the impact of childhood trauma.¹ No matter what your experience looks like, these effects aren't a reflection of your character.

Children who grow up with a parent with alcohol use disorder may face a higher risk of abuse, neglect, and other adverse childhood experiences (ACES), though alcohol use alone doesn’t make someone abusive.²

Research suggests that parental alcohol misuse can increase a child's vulnerability to harm and create instability in the home. Child neglect may also happen more often in these families.²

It may feel like no one understands what you've been through, but you're not alone. In the U.S., there are over 76 million ACoAs, and many share similar experiences.¹

One common experience for ACoAs is growing up in a home with unspoken rules they follow to avoid trouble:

1. Keep the addiction and any other family problems a secret.
2. Hide your feelings.
3. Always be perfect.
4. Taking care of your needs is selfish.
5. Avoid relaxing or playing.
6. Avoid conflict at all costs.

These rules can teach you that trusting others, expressing your needs, and showing feelings are unsafe. When you learn these lessons while you're still growing, you may carry them into adulthood.

Common Traits of ACoAs

Because children of parents with alcohol use disorder often go through similar stress and trauma, many ACoAs face similar challenges.

Distrust of Others

It can feel confusing when a parent shows love one moment and then acts cold or cruel the next. Alcohol use can also become a parent's main focus. When that happens, bills, meals, work, and school events may get less attention.

Over time, you may learn that you can't count on others for consistent care.³

The outside world can feel unsafe when you grow up with a parent with alcohol use disorder. Your parent may pressure you to keep family problems secret. You may also worry that telling a teacher or friend could lead to consequences for your family or for you. Adults and systems that are meant to protect you may start to feel frightening.

This distrust can make it harder to accept support from others. It can also make ACoAs more vulnerable to gaslighting. You may feel safer handling everything alone. Even when you start to rely on others, you might fear abandonment.¹

If your childhood felt unpredictable, it can be hard to believe love will stay steady.

Hyper-Responsibility or Avoiding Responsibility

Many ACoAs feel responsible for their parent's drinking and its consequences. Sometimes a parent blames their child directly through words or actions.

Over time, you may start to believe that you're responsible for bad outcomes, while good outcomes happen by luck. This can lead to an unhealthy sense of responsibility.¹

Many ACoAs also grow up feeling like it's their job to keep the family going. You may start working early to help pay bills or take on a parenting role for younger siblings.

This hyper-responsibility can continue into adulthood. You may feel responsible for everyone else's happiness and well-being, even when that feels overwhelming.¹

On the other hand, some children who grow up with a parent with alcohol use disorder may avoid responsibility as a way to cope.¹ They may rely on others to manage daily tasks.

This can happen when nobody teaches them how to identify needs, ask for help, or build life skills. Over time, they may feel unsure of their abilities because they get fewer chances to practice independence.¹

Perfectionism

Many ACoAs look for approval through achievements, which can feel like an escape from stress at home. When you don't get steady affection just for being you, you may start to feel worthy only when you perform well. School and activities can also feel like the areas you control the most when you're young.

This drive for success, along with self-blame about your parents' drinking, can turn into perfectionism. You may focus on avoiding criticism or blame. Over time, mistakes can feel scary. Some ACoAs also struggle to relax or have fun because staying in control feels safer.

This can feel exhausting and may lead to burnout. You deserve care and kindness, no matter what you achieve. Treatment, including rehab or therapy, can help you build self-worth and self-compassion.

Negative Self-View

Some research links parental alcohol misuse with lower self-esteem in children.⁴ A common reason is self-blame. Your parent may say they drink because of your behavior. They may also create conflict and then say they "need a drink" to calm down.

If you blame yourself for a serious problem at a young age, you may start to believe something is wrong with you.

Some ACoAs also learn that their needs matter less than everyone else's. You may hear that meeting your needs is selfish. Your sense of worth can become tied to how well you take care of other people.

But your needs matter, too, and learning to talk about them can support healthier adult relationships.¹

Emotional Dysregulation

Many ACoAs have trouble managing emotions, which clinicians often call emotional dysregulation.⁵

You may not have grown up with good examples of emotional coping. You might have seen a parent use alcohol to numb hard feelings. You might also have seen intense mood swings during or after drinking.

Over time, it can feel harder to manage your emotions or respond calmly to other people's emotions.

Anger can feel especially hard. Seeing a parent's rage can feel frightening when you're young. You may start to fear your own anger and try to control it at all times.

Rehab and therapy can help you build skills to notice emotions, respond with intention, and feel safer with what you feel.

Conflict Avoidance

In many homes affected by alcohol use disorder, conflict feels frequent and intense. Without a healthy model for problem-solving, many children cope by avoiding conflict. That may look like hiding in your room or dissociating, which means feeling disconnected from your thoughts, body, or surroundings.⁶

These responses can help you feel safer in the moment. But over time, they can make it harder to handle conflict in a healthy way.

You may also feel pressure to keep the family stable, which can lead to ignoring major problems. As an adult, avoiding conflict can affect your mental, physical, and social wellbeing.

These challenges can continue into adulthood. Some people still feel the effects later in life, including older adults.⁷

The Impact of Growing Up With a Parent With Alcohol Use Disorder

Growing up in a home affected by alcohol use disorder can feel chaotic. It may feel hard to predict what will happen next. You may not know when your needs will get met or ignored. Over time, that unpredictability can affect your health and relationships.

Increased Risk of Substance Use

Some research suggests ACoAs may have a higher risk of alcohol use disorder.⁵

Children of parents with alcohol use disorder may also have a higher risk of developing substance use disorders, including drug use disorders. This risk relates to genetic, environmental, and developmental factors, and it isn't your destiny.⁸

This risk may relate to genetics, coping patterns you learned at home, or childhood abuse and neglect.²

Difficulties in Relationships

Some ACoAs report trouble forming and keeping healthy relationships, including romantic relationships.³

If you couldn't trust your parent for consistent support, intimacy may feel risky in adulthood. If alcohol use shaped the relationship you saw at home, you may also feel unsure about what healthy partnership looks like.

Every relationship has some conflict. If you didn't learn healthy ways to work through disagreements, conflict may trigger anger. You may also avoid conflict by acting like the problem isn't there.

Physical Health Issues

Childhood stress can affect your physical health. Some studies link adverse childhood experiences to higher risk for certain health concerns later in life, including:²

• Diabetes.
• Sleep problems, including insomnia.
• Fatigue.
• Gastrointestinal disease.
• Cancer.
• Heart disease.
• Cirrhosis.

Mental Health Issues

Instability in childhood can affect your mental health as you grow older.⁷ Research suggests ACoAs may have a higher risk for some mental health diagnoses, including:⁵

• Anxiety.
• Depression.
• Obsessive-compulsive disorder (OCD).
• Attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD).
• Personality disorders, including antisocial personality disorder (ASPD).

Post-traumatic stress disorder (PTSD) can also happen after ongoing childhood stress or trauma, including growing up in a home affected by alcohol use disorder.⁷

Simple and Complex Post-Traumatic Stress Disorder (CPTSD)

Alcohol use disorder can create stress and instability for the whole family. Childhood trauma can affect you in many ways, sometimes without you realizing it.

Many ACoAs report symptoms of PTSD. For example, hypervigilance (feeling constantly on alert) can be a PTSD symptom, and some research suggests ACoAs may develop this from a young age.¹

Some ACoAs also experience symptoms linked to complex PTSD (CPTSD), which can develop after long-term trauma. These symptoms may include:⁸

1. Difficulty managing emotions.
2. A negative self-view.
3. Trouble forming and keeping healthy relationships.

Even without a diagnosis, childhood trauma can affect mental health over time.⁹ Many rehabs offer evidence-based trauma treatments to help you heal, build coping skills, and improve communication.

Strategies for Healing and Moving Forward

Emotional Sobriety

Tian Dayton, psychologist and author of ACoA Trauma Syndrome, compares growing up with addiction to secondhand smoke:

We inhale the thinking, feeling, and behavior of the addict emotionally, psychologically, and behaviorally; we take who they are while using, into our own inner world…Many of the clients that I treat have never had a problem with substance abuse. But they still act drunk.

Tian DaytonPsychologist and Author of ACoA Trauma Syndrome

"Emotional sobriety" is a phrase some people use to describe building healthier emotional balance and coping. It may include learning how to notice feelings, manage stress, and respond with intention.¹¹

Because emotional coping is a common struggle for ACoAs, building these skills can be an important part of healing.

Rehab for ACoAs

Many places offer support. Some rehabs even offer programs that focus on ACoA-related trauma.

Trauma-informed residential rehab programs, for example, may offer a mix of peer support and therapies. Some rehabs may also specialize in support for ACoAs.

For example, one of the nine phases of Affect2U's treatment program focuses on ACoA-related challenges. If you're unsure whether a rehab offers this type of support, you can call the center’s admissions team and ask what services they provide.

Rehab can help you work through childhood trauma, treat alcohol use disorder or other mental health diagnoses, and build coping skills. In a residential program, you get space away from daily stress. You can also work with professionals who understand childhood trauma and its long-term effects, and you can try different therapy approaches.

Treatment Options in Rehab

Some rehabs offer family therapy, which can help reopen communication, and it can support healthier ways of relating to each other. Family therapy in rehab can also help you practice conflict skills with the people closest to you.

Behavioral therapies are another option for ACoAs.¹ Cognitive behavioral therapy (CBT), for example, can help you notice unhelpful thoughts, practice new coping skills, and build healthier behavior patterns.

Resources for ACoAs and Their Families

Support Groups

Support groups can offer a sense of community and understanding.

Many rehabs include group therapy or peer support meetings for people with similar experiences.

You may attend meetings like Alcoholics Anonymous. Even if you don't have alcohol use disorder, these meetings may help you understand how alcohol use affects families.

Some rehabs also offer Al-Anon meetings for loved ones of people with alcohol use disorder.

You can also attend meetings outside of rehab. Many people find support from others who understand what they're going through. Al-Anon and other groups offer virtual meetings for convenience.

Books for ACoAs

Books about growing up with a parent with alcohol use disorder can expand your understanding of your experiences:

• The Complete ACoA Sourcebook: Likeskills for Adults, and Struggle for Intimacy by Janet G. Woititz
• Recovery: A Guide for Adult Children of Alcoholics by Herbert Gravitz and Julie D. Bowden
• Emotional Sobriety: From Relationship Trauma to Resilience and Balance by Tian Dayton
• Waking the Tiger: Healing Trauma by Peter Levine
• Getting the Love You Want by Harville Hendrix, PhD, and Helen LaKelly Hunt, PhD

Take Back Control of Your Life With Trauma-Informed Treatment

When you're a child, much of life feels out of your control. Growing up with a parent with alcohol use disorder can add even more uncertainty. As an adult, you can choose what happens next. You can also choose support that fits your needs.

You deserve support, and rehab can be part of that support. A program that treats ACoA-related trauma can offer care, expertise, and structure.

Explore rehabs that treat trauma to learn more about treatment settings (including inpatient and outpatient options), treatment modalities, pricing, and more, and reach out to centers directly.