Problem drinking has multiple causes, with genetic, physiological, psychological and social factors all playing a role (Sher & Trull). For some alcoholics, psychological traits such as impulsiveness, low self-esteem and a need for approval prompt inappropriate drinking. Others drink as a way of coping with emotional pain. Still others use alcohol to "medicate themselves". Heavy drinking can cause physiological changes that make more drinking the only way to avoid discomfort. Genetic factors cause some people to be especially vulnerable to alcohol. However, a family history of alcoholism doesn't mean that children of alcoholics will automatically grow up to become alcoholics themselves. Environmental factors such as peer pressure and the easy availability of alcohol can also play roles. Although alcohol-related disorders can strike anyone, poverty and physical or sexual abuse also increase the odds. Alcoholics, as a group, tend to demand a lot of themselves as individiuals. They put an enormous amont of emphasis on trying to please others and themselves. The frustration that can become of this is all but pleasing. They may become pinfully depressed or overly agressive causing family life to deteriorate rapidly (Family). If the person is married, the significant other is forced to make a decision as to whether they are going to stay with the alcoholic or not. Many families try to deny the fact that the person is an alcoholic causing the situation to deteriorate even further. One may wonder how alcoholisim affects the family. By allowing an alcoholic's behavior to be controlled by a substance, the abuser, family members, friends and colleagues unknowingly become part of the problem. Substance abusers cannot stop the habit of drinking without the help of others. Abusing alcohol can have several effects on the family. These things can be anything like a lack of trust in other people, difficulty expressing feelings, working hard to keep things going at home and school, insecurity, loneliness, anger, frustration, guilt, and fear (Family).