Recovering Couples

It has been a long delay since my last blog entry, a very busy year professionally and personally. I do hope to keep momentum going with raising the issue of relationships and addiction recovery.

The blog title is taken from a piece of Christmas folk lore. In 1897 little eight-year-old Virginia O’Hanlon wrote a letter to the New York Sun asking for the truth about whether there really is a Santa Claus, because  her friends told her there wasn’t. The editor, Francis P. Church, wrote the following:

“Virginia, your little friends are wrong. They have been affected by the skepticism of a skeptical age. They do not believe except they see. They think that nothing can be which is not comprehensible by their little minds… Yes, Virginia, there is a Santa Claus. He exists as certainly as love and generosity and devotion exist, and you know that they abound and give to your life its highest beauty and joy.”

Church’s response was an instant sensation and has become one of the most famous editorials ever written. It was reprinted in the Sun annually until 1949, when the paper went out of business.

So what does this have to do with couples and recovery? The long held belief in the addiction recovery field has been to keep recoveries separate, each individual is encouraged to work their own program and “stay on your own side of the street”. As a recovery therapist, I can’t argue with the emphasis that should be placed on individual recovery. However, by adding a relationship focus in the recovery process you address a way of helping couples and families in the transition through the stages of recovery, in my opinion, is core to a more holistic approach to recovery. My research on successful long-term recovery processes points to the very important role of couple and family relationships can have have in successful outcomes.      

My colleague and friend, Dr. Virginia Lewis is Co-Founder and Co-Director of the Family Recovery Project, at Mental Research Institute (MRI) in Palo Alto. Additionally, she is Senior Research Fellow at MRI and an excellent clinician in private practice. Virginia invited me to continue my research on couples in recovery and together we co-founded Center for Coupes in Recovery at MRI. Virginia’s emphasis on family recovery as an essential component of successful long-term recovery, focuses on the importance of relationships in recovery, describing the complexities and difficulties families encounter, and normalizing those challenges.

There are many in the field that don’t believe in a relational approach to addiction treatment. To them I would say, “Yes, Virginia is right, there is family recovery: It’s exists. Let’s work together to help couples and families manage better, and educate those who don’t believe.”

OK, you are in recovery for an addiction or for codependency. Everyone is telling you to work your own program, focus on yourself and on your recovery. The message is  very clear: For now, put your relationship on the back burner. That sounds right to you, but the problem is that everyday you are struggling in your relationship. Increasingly you are feeling distant from your partner and you don’t know if you should even address your relationship concerns, after all, you are supposed to focus only on yourself. Feeling puzzled about where to place your relationship?

As a therapist and researcher I am interested in the “big picture” of addiction recovery. I have learned from my research couples that by addressing individual recoveries and relationship issues, you are creating the best opportunity for successful long-term recovery. A study by Humphrey, Coos, and Cohen (1995) supports this idea. The study followed 385 previously untreated alcoholics at three years and eight years after treatment to find out what factors led to successful long-term recovery. The results from the study indicate that the quality of family relationships is the most predictive variable of whether the alcoholic will maintain successful recovery eight years after treatment.  Additionally, outpatient or therapy sessions and attendance in AA sought in the first three years of recovery increased the likihood of continued recovery at the eight-year mark.  

We know that couples with alcohol problems have higher rates of divorce than the general population and we know that recovery does not necessarily reverse that trend. I believe that the recovery jigsaw puzzle challenges us to try to figure out where to place the relationship piece. Where that piece is placed is going to vary from couple to couple and will depend on a number of factors. I have met with tremendous resistance in the recovery field to this idea, but based on my research and other research that supports this position, I think they are wrong. 

I am interested in hearing from couples and from recovery professionals about your experiences addressing relationship issues in the context of addiction recovery. What has worked, what has not worked, what ideas do you have on how to figure out where to place that puzzle piece? My ongoing research on recovering couples is based on learning from the folks who are in the middle of it. I will post comments and hopefully we can create dialogue.    

There are many paths to recovery; one size does not fit all. One path is inpatient treatment. As a therapist working with couples before and after inpatient treatment I have found a glaring difficulty for many of the couples: they are on completely different paths from each other. The following are “composites” of the stories I have heard from couples when a partner has been in rehab.

John was admitted to an out of state “name brand” rehab unit. His partner, Mary, initially received a telephone call from the case worker to get some information about the family, and Mary was given information about family week. John was in treatment for over 70 days, during which time Mary’s phone calls to the program were essentially ignored and no further contact from them was made until family week, two days before John’s scheduled discharge. Their response to her anxiety about what happens after inpatient treatment: “Go to Al-Anon and work on your own program”. 

Alan wondered why the family therapist at the program that his wife was admitted to keep talking about his contribution to her drinking, and how he needed to support her in new ways. While he felt this was a very important thing to discuss, he wondered why nobody seemed interested in how his wife’s alcoholism of the last 11 years has affected him and their family. He was told to work his own program, which Alan was willing to do, but Alan also wanted to know how they could deal issues as a couple. There were a lot of responsibilities and issues that still needed to be addressed: their son’s school difficulties, finances, and her parents intrusion into their lives, to name a few. He was told to put these issues on hold for now.

Carol didn’t understand why Jim had to go to so many AA meetings, after all, he stopped drinking and she needed him to help out more at home and with the kids: she felt depleted. Jim was panicked, Carol was pressuring him to not go to the Thursday night meeting, Jimmy needed help with homework. This was his home meeting and the place he felt he got the most support after leaving the hospital. It felt like a no win situation to the both of them

These different paths need to be identified, named, and explored, creating a dialogue around the impact of addiction and recovery on the relationship. It is important that partners work their own program and get support for themselves outside of the relationship. The piece worth adding is: How can couples support each other’s recoveries and at the same time not sacrifice their own?

Couple recovery means at the very least acknowledging that there are three concurrent recoveries: Each person’s individual recovery, and the couple relationship in the context of recovery. My belief is that treatment programs too often heavily emphasize the addiction recovery, they suggest recovery for the other person, and completely ignore the couple relationship. It’s time to look at the bigger picture and all the challenging questions that come with that awareness: How can we best support people in their recoveries and in their relationships?