This paper reviews the film When a Man Loves a Woman, and reflects on the health-care issues explored within the narrative of the film. In particular, it considers the issue of alcoholism, and the related issue of substance abuse. The paper explores the physical, mental, and social impacts of substance abuse and alcoholism on individuals, families, and society as a whole, using the film as a lens for examining the real-life implications of these issues. Finally, the paper explores the Transtheoretical Model of Health Behavior Change, and the stages of change as they are illustrated within the film, as well as exploring the implications of the film for health-care and counselling practices.
Although it can sometimes be a taboo subject in Western culture, alcoholism is a real problem and causes both mental suffering, social challenges, and health issues to the hundreds and thousands of people who suffer from it. Produced in 1994, the film When a Man Loves a Woman (Avnet and Mandoki, 1994) dramatizes this problem, bringing its reality and challenges to public awareness.
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The film tells the story of a young wife and mother, Alice, whose alcoholism is having a severe impact not only on her health but, more crucially, on her relationship with her family. Alice’s dependence on alcohol marks her as the character in the film most affected by substance abuse. Although usually a fun-loving, affectionate and caring individual, Alice exhibits symptoms of mood and personality change when under the influence of alcohol, becoming angry and even violent towards those who love her. She is dependent on alcohol to perform every-day tasks, and her dependency on the drug makes her, in turn, dependent on her husband to hold their family together. It was heart-breaking when watching this film to see how, despite Alice’s clear love for her family, alcohol prevented her from being a good mother and wife.
It reminded me of so many families within my experience whose genuine love is marred or even destroyed by problems which to them feel out of their control, but which to the rest of the world may seem obviously and easily solvable. An example is a family I knew as a child, in which one parent suffered from bipolar disease. Although the disease caused this parent to have unpredictable mood-swings and occasionally abusive behaviour, it would also cause periods of affection and generosity. Unable to see the impact of this behaviour on the family, the parent suffering from bipolar refused to take the prescribed medication, resulting in the eventual loss of his family. As the film demonstrated, the feelings of isolation that this disjuncture between experience and public judgement can create can be as damaging as the substance abuse itself, making the re-establishment of self-esteem a fundamental part of any cure for the individual.
Essential to the narrative of the film was the idea that Alice and her family were aware of the problems they faced, and determined to change their situation. In this sense, the film provides an excellent illustration of the “action” stage of change, according to the Transtheoretical Model of Health Behavior Change. According to the HABITS Lab at UMBC, this stage of change “marks the beginning of actual change in the criterion behaviour” (University of Maryland, 2017, n.p.). In the early stages of the film, Alice exhibits classic signs of earlier stages of change: her denial when confronted by her daughter, for example, is a clear demonstration of the precontemplation stage, in which the individual either denies the problem or exhibits no intention to change (University of Maryland, 2017, n.p.).
However, after an alcohol-induced attack on her daughter and a near-fatal fall in the shower, Alice realises her drinking is a serious problem, and takes immediate steps – with the help and support of her family – to change. Her enrolment in a rehabilitation clinic marks her adoption of the “action” stage of change, and her rapid improvement from that point on shows her progression to the “maintenance” stage. It seems clear that Alice can be considered to be in the “active” stage of change after her enrolment at the clinic because she is no longer merely intending to change, but has taken actual, concrete steps to achieve that change.
Reflection on both this dramatization of the model and my own experiences of problems and change within families, it seems clear that one of the greatest challenges pertaining to any kind of long-term change comes from the need for self-belief and motivation in maintaining change and progress. In the situation described above, for example, the individual in question was never able to move beyond the contemplation or preparation stages of change within the model, because he lacked the self-confidence to believe that his family would continue to love and support him even if his controlling and abusive behaviour stopped. This problem was further exacerbated by his own belief that needing medication to control his problem was a sign of personal weakness and failure. Unlike Alice, this individual did not have the courage to recognise his problem and believe in himself enough to take action to fix it. As Alice’s story demonstrates, however, self-belief is necessary to move from contemplation to action. By sustaining that self-belief, not only can the problem be solved, but life overall can become more positive and fulfilling.
My overall reaction to this film was to feel encouraged and inspired by the film’s assertion that both individuals and families can find the strength and courage to confront and solve the problems of substance abuse. I feel that this message is particularly important because a key contributor to the seriousness of these problems in our society is that fact that it is taboo: people do not like to admit that they (or their loved one) may suffer from a substance abuse problem, and society attaches significant stigma to those who do make such an admission.
These personal and social penalties for recognition of the problem can make it difficult to find the mental reserves of belief and courage needed to overcome the problem and take action to change. However, given the clear health issues associated with substance abuse, this change is vital to personal and social health. Alcoholism, for example, is a key cause of injury, death, reproductive health issues, and even cancer (CDC, “Women’s Health”, 2017; CDC, “Men’s Health”, 2017). Taken on top of the clear negative impact of substance abuse on family relationship and social participation, it is clear that for individuals affected by substance abuse, change is necessary and crucial.
As a health counsellor, my recommendation to this family would have centered on strategies designed to increase motivation to change, and to encourage the self-esteem necessary to maintain change. A first strategy would be to educate the family about the Transtheoretical Model of Health Behavior Change, and the stages of change associated with alcoholism, using their own testimony and experiences to provide concrete examples of how the model applied to them. In this way, I would hope to reinforce their recognition not only of the problem, but also of their own potential ability to solve it. As a further strategy, I would encourage this family to set goals together, and monitor their progress towards those goals, with an emphasis on positive language and success: in so doing, this family could maximise the benefit of their pre-existing motivation, and hopefully be motivated to reach the “maintenance” stage of change. By encouraging this family to work together and be open about their challenges, I would hope that these strategies would overcome some of the social and mental contributing factors which often lead to failure for those recovering from substance abuse conditions.
Overall, When a Man Loves a Woman is a valuable contribution to discourses about substance abuse within American society. By bringing the problem into the open, and demonstrating the positive effects of taking steps towards change, this film encourages viewers to believe that these problems need to be talked about, and that cures need to be publically supported, rather than publically shamed.
