Recovering Couples

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.    

Addiction is described as a cunning, baffling, and powerful disease; the impact on relationships is devastating. When a partner is addicted, everything in the relationship changes. When the addict/alcoholic is in the middle of the disease denial buffers the addicted person from acknowledging the reality of their addiction and how it is affecting those around them. It is hard for partners to understand why their loved one doesn’t see the damage or do something about it. It seems so clear, yet, there often is tremendous resistance and anger directed at the non addicted partner. 

In Wikianswer.com, being behind the 8-ball is described as this: “In the game of pool, the 8-ball is the last ball a player must sink in order to win the game. However, until he or she has sunk all the rest of the balls (i.e. 1 through 7 or 9 through 15), touching the 8-ball with the cue ball is considered a foul stroke. Therefore, one is said to be ‘behind the 8-ball’, it means to be stuck in a position where any move will have a negative result — to be trapped with no way forward.” If you are in this situation, I imagine this sounds and feels familiar. I call this the “8-Ball Dynamic” because in active addiction, addicts often are very skilled at putting their partners behind the 8-ball: Efforts to get help, or address problems in the relationship, or simply trying to enlist support to manage the responsibilities of  life are met with anger, blocks, challenges, and obstacles of all sorts.

It is important for partners to understand that the drug of choice (or addictive behavior) is the primary relationship for the addict. When someone is in the middle of their addiction, reason and judgment are impaired. The biological impact of chemicals on brain functioning and the psychological mechanisms of denial, projection of blame, and minimization all serve to keep the addict from accepting the reality of addiction. 

I worked in a drug and alcohol treatment program years ago and learned that the staff could never really tell initially who was going to be successful or drop out of the program. Those patients that at first looked motivated could still relapse. Those most resistant to treatment sometimes proved to be the poster child for addiction recovery. We never know what will happen; people can come to that place of “surrender” and suddenly “get it”. In the meantime, all that one can do is to focus on taking care of themselves. Get help and support, go to Al-Anon and/or other support groups. Remember you can’t control your partner, no matter how loving or how angry you get. Recognize the “8-ball dynamic” for what it is, a symptom of active addiction. Don’t buy into the blame or accusations of why the addict is using, instead try to focus on help for yourself. It is a hard thing to do, but you don’t have to stay behind that 8-ball.       

Paul and Alice were struggling in their relationship. I started working with them after Paul got into recovery from alcoholism and a gambling addiction. Alice was in individual therapy and attending Al-Anon, Paul attended AA and Gamblers Anonymous (GA). We had been meeting for two months when the therapy session focused on how they both felt distant from each other, and recalled how things used to be. We talked about what things were like for them during better times. 

They had a lot of history together, many positive times, some painful times. As Paul’s addictions progressed, the negative overtook the positive in the relationship. Recovery is a process and healing takes time. We talked about how important is to share with your partner what you appreciate about the partner, what you like about their qualities. Dr. John Gottman’s research on couples uncovered a very important finding: managing conflict and dealing with the painful parts of the relationship goes much better when there is a foundation of positivity in the relationship. All this means is not just focusing on the negative, and the hurt, but remembering and acknowledging the positive. Even in the most distressed relationships I found that when couples are able to tap into something positive to say to their partner, things go better and actually make dealing with the difficult issues go a bit more easily.

In the session I asked each person to share several things they appreciated about the partner. They had not heard anything positive from the other person in such a long time that they both felt moved by the sincere appreciations that were shared. Paul then said that he felt it was hard to hear anything positive from Alice, he felt shame about how his addictions had damaged their relationship. We discussed those feelings, but also focused on how important it is to put toxic shame in the box of “Not Helpful” because shame is about feeling that there is something wrong with who we are, not that what we did. Paul grew up in a very toxic family, he heard messages his entire life that he was defective and bad. Guilt helps keep is from getting off track from the things we value or the beliefs we have - that is healthy.

Paul heard the difference between toxic shame and guilt,  and is working on it. He is trying to let the positive appreciations sink in, and this is good for Paul and for the relationship. It will help Paul and Alice deal with other things and keep a perspective of accountability, not despicability - a huge difference.

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?