Many of these adults are involved in some type of cohabiting relationship, and these partners are feeling the painful repercussions of alcohol or drug abuse. Whether this relationship involves marriage, a domestic partnership, or a more informal living arrangement, substance abuse affects everyone in the home, not just the individual who is addicted. Effective therapeutic interventions involve both partners as well as their children.
The American Association for Marriage and Family Therapy describes a cycle of conflict that occurs in domestic partnerships, in which substance abuse leads to verbal and physical conflict, which in turn leads to further disagreements about the substance abuse itself. Before long, addiction becomes the focal point of the couple’s conflicts, and other sources of tension may be temporarily suppressed. However, these sources of disagreement will come back to the surface eventually, especially if the couple denies the problem and refuses therapy.
Alcohol and drugs can impair judgment, arouse feelings of anger and resentment, and create an atmosphere that leads to conflict at home. In the worst cases, these unmanageable emotions lead to violence, verbal and physical abuse, harm, and even death. The National Resource Center on Domestic Violence estimates that approximately 50 percent of men who are in treatment for substance abuse have a history of physically abusing their wives or partners, and that a significant number of women in treatment programs have been the victims of domestic violence.
Any experiences of abuse or potential signs of abuse must be taken very seriously in recovery. Individuals who have verbally abused or physically attacked their partners will require anger management courses and may face legal consequences, depending on the severity of the assault. Anyone who feels that they are in danger because of an abusive partner should seek help immediately from legal authorities, a healthcare provider, or a substance abuse treatment professional. Online resources and support services on partner abuse are available through the National Domestic Violence Hotline.
These are key questions for anyone who has a spouse or partner in recovery. Offering support to an addicted partner can take a tremendous toll on your physical energy and emotional health. On top of this, the needs of the rest of the family, such as children and aging parents, and the demands of work and social commitments can quickly become overwhelming.
The checklist below includes guidelines that can help you provide support in a healthy and meaningful way. If you feel that you are losing yourself in another person’s struggle, or you’re overwhelmed by the responsibilities of family life, work, and recovery, these “reality checks” can help you reorient yourself and redirect your energies:
Am I setting healthy boundaries for myself? (e.g., not letting my boyfriend’s bad mood affect my outlook on the day)
Am I letting the people in my life take responsibility for themselves? (e.g., letting my kids arrange their own transportation to afterschool activities, letting my boss pick up her own dry cleaning)
Am I seeking help from professionals outside the home? (e.g., calling a loved one if I feel overwhelmed, talking with a family therapist if I can’t manage a conflict with my spouse)
Am I taking time to eat healthy foods and get physical exercise? (e.g., taking 10 minutes before work to make a healthy homemade lunch, walking the dog for a half-hour in the evening)
Am I giving myself time for my own stress management activities? (e.g., going to a yoga class, meditating for 10 minutes, listening to an inspirational audiobook, meeting a supportive friend for coffee)
Am I making time for my own recovery activities? (e.g., going to an Al-Anon meeting, reading recovery literature, attending an individual session with a counselor or therapist)
In the past, addiction was viewed as an individual problem that was best resolved by focusing attention on the person abusing alcohol or drugs. However, the mental health community now views the Family Systems Model as a more accurate reflection of the way addiction develops. In the Family Systems Model, substance abuse arises as a result of dysfunction among the members of a family unit. Likewise, the most effective way to resolve addiction is to work with all the members of the household to improve their communication patterns and create a healthier home environment. According to the journal Science & Practice Perspectives, therapies that focus on treating both members of a couple have a higher success rate at maintaining long-term abstinence than therapies that address only the individual with the substance use disorder.
BCT can be applied as part of an inpatient substance abuse treatment program or through outpatient therapy sessions. The core strategies of BCT have been applied through other therapeutic approaches to provide similar benefits.
Support groups like Al-Anon and Nar-Anon are based on the 12-Step principles of Alcoholics Anonymous. Through these confidential groups, members gather and work on a one-on-one basis with a sponsor to build inner strength and learn how to detach lovingly from the struggles of others. Twelve-Step groups meet at rehab centers, in outpatient programs, and throughout most major communities. Membership is free; participants are asked only to make a small monetary donation and to contribute some of their time to group activities.
Al-Anon and other 12-Step groups are based on a spiritual approach to recovery, and members are encouraged to seek support from a higher power of their own choosing. These groups are nondenominational, and no preference is shown for any organized religion.
For those who prefer a secular approach to recovery, support groups like SMART Recovery, Rational Recovery, and Secular Organizations for Sobriety (SOS) offer nonreligious programs that are available in many communities. In addition, nondenominational self-help groups or group counseling services are available through community centers, mental health services, and private therapists. Many rehab facilities offer support groups and other services through their alumni programs, for clients and their loved ones who have been through treatment.
Regardless of the approach you and your partner take to recovery, seeking support from others is one of the primary ways to maintain long-term abstinence. In a study of individuals who had maintained their sobriety for a median of 12 years, the Journal of Psychoactive Drugs cites the following as the most important factors contributing to their abstinence:
The following checklist can be used as a guide to creating a home that supports long-term recovery after rehab:
No illegal drugs or drug paraphernalia
No easy access to prescription drugs with a high abuse potential, like narcotic pain relievers, sedatives, and stimulants (These should be locked in secure areas if they are necessary, or they should be removed if they are not being used with a valid prescription for medical reasons.)[/columns]
No posters, wall hangings, or other decorative items that suggest or advocate substance abuse
Healthy snacks, such as fresh fruit, yogurt, or popcorn, to provide energy
Lots of nonalcoholic liquids, such as bottled water, juice, tea, or carbonated soft drinks, to provide hydration
A clean, uncluttered environment, with lots of light and fresh air
Comfortable pillows or beanbags for rest, relaxation, and a sense of security
Recovery literature in easily accessible places, like bedside tables or bookshelves
Inspirational calendars or posters to remind you and your partner of your recovery goals
House plants or fresh flowers on windowsills and tables, to signify new growth
If providing a sober environment is not possible immediately after rehab, or if the recovering partner needs more structure or supervision, a sober housing program can provide an effective transition from rehab back to the home. In sober living programs, housing is provided within the community, in a home that is structured by rules and expectations about maintaining sobriety.
In sober living programs, residents generally live in houses that are located in mainstream neighborhoods, where they have easy access to meetings, clinics, counselors, and jobs.
Residents are expected to follow specific rules in order to maintain their residency, such as:
If an individual who has completed rehab is to maintain long-term abstinence, their partner should be equally committed to the recovery process. Ideally, this commitment should include the intention to remain sober. However, if the other partner is not ready to be completely abstinent, a sober living program could provide a safe haven for the recovering partner to practice the coping strategies learned in rehab without the triggers or stressors of life at home.
When both members of a relationship are committed to recovery, it is possible to regain lost trust and repair the bonds that were broken by addiction. In order to do this, couples need the guidance and support of professional marriage counselors, therapists, or social workers who have specialized training and credentials in substance abuse treatment. These professionals can address not only the issue of drug or alcohol abuse, but the sources of conflict that have been suppressed through years of focusing on addiction.