High-functioning addicts — a term attributed to people who have substance use disorders yet manage…
The Myth of the ‘High-Functioning Alcoholic’
Ask any cartoonist to sketch up an image of an alcoholic and you’ll get the easily recognizable stereotype: older, male, publicly drunk and hanging on a streetlamp. Obviously that picture is of a “dysfunctional” person, but what is a functioning alcoholic? How do functioning alcoholics differ from this stereotype?
A functional alcoholic, sometimes referred to as a “high-functioning alcoholic” (HFA), does not fit into the “skid row” stereotype, but is addicted to alcohol just the same. These are people who pay their bills on time, maintain high-powered careers, perhaps even winning awards, honors, or accolades for their public accomplishments. What are the characteristics of people who struggle with alcoholism and yet maintain a highly functional lifestyle?
Denial is a key defense mechanism used by functional alcoholics. These folks cite their functioning as evidence that they do not have a problem with alcohol. Every success or accomplishment is held up as proof that they are not an alcoholic. They may point out that “real alcoholics” have lives that are spiraling out of control, and are quick to point out how different they are from that skid row bum. Sipping fine wine, for example, is seen as a part of their successful lifestyle and thus couldn’t be an indication of a problem or addiction.
What is a functioning alcoholic? At its core, these behaviors can best be understood as keeping up appearances. People who manage to balance their addiction to alcohol with the appearance of a successful career and happy home life do so by adopting a rigid perfectionism when it comes to how things look to outsiders. They do everything right, or so it seems.
Their inner life, however, is typically much less polished. Emotionally, they may feel much more insecure, fearful, or resentful about life and feel that their drinking is an earned reward. Often they know, deep down, that their drinking is an issue, and they feel guilt or shame about it.
Because of their robust denial and perfectionism, it can be difficult to discuss problem drinking with these people. That doesn’t mean expressing your concerns or feelings isn’t recommended — it is. But be ready for the process of understanding and admitting to a problem to be a long and winding road.