Marriage/partnership and alcoholism
Marriage and partnerships can be profoundly affected by alcoholism, also known as alcohol use disorder (AUD). This condition not only impacts the individual struggling with alcohol but also places significant emotional and physical strain on their partners. Research indicates that relationship dissatisfaction is common in partnerships where one partner has AUD, often leading to increased tension and conflict. Moreover, alcohol abuse is linked to higher divorce rates, with statistics suggesting that one-half of divorces in the U.S. involve at least one partner abusing alcohol.
The dynamics within these relationships can become distorted, as partners may adopt a caretaker role, striving to manage the drinking behavior while neglecting their own needs. This can create a cycle of anxiety and frustration that impacts the entire family unit. Although there is no concrete causal link between AUD and family violence, excessive drinking is known to escalate conflict, potentially leading to aggression.
Intervention strategies for couples dealing with AUD often include therapy aimed at addressing the relational challenges posed by the disorder. Support groups, such as Alcoholics Anonymous and Al-Anon, can also play a crucial role in fostering understanding and emotional support for both individuals in the relationship. Overall, navigating a partnership affected by alcoholism requires sensitivity, open communication, and a commitment to recovery for both parties involved.
Marriage/partnership and alcoholism
DEFINITION: Alcoholism, commonly called alcohol use disorder (AUD), often affects marriages and other domestic partnerships. Partners are at risk for developing serious physical and emotional problems. Most literature has focused on men in relationships because alcohol abuse is more common among men, although statistics show that alcohol abuse by women is increasing and nearing the rate equal to men. It is estimated that one-half of all divorces in the United States occur in families in which at least one person has abused alcohol. Other divorce statistics indicate that a one-liter increase in the average alcohol consumption of a given area results in up to 20 percent higher divorce rates.
Introduction
In the early 1930s, social workers in state hospitals reported their observations of the wives of men with AUD, describing the wives as having anxiety, depression, and psychosomatic symptoms. The social workers suggested that such psychological symptoms were not caused by living with an individual with AUD; instead, the women who displayed such symptoms were using their marriages to men with AUD to resolve their own neurotic conflicts. Furthermore, it was suggested that if the male would decrease his drinking, the wife would suffer from the loss of a defense mechanism.
In the 1950s and 1960s, theory and treatment options shifted this view to one in which family members’ symptoms were viewed as a normal process in a high-stress environment with care similar to that required for a chronically ill spouse or partner. Continued research has focused on the interactive process between individuals with AUD and others in close relationships with them.
Spouse/Partner Relationships with AUD
Addiction to alcohol is a relationship issue. Being married to or in a domestic partnership with an individual with AUD places a strain on that relationship, causing one partner to take on responsibilities that would not be expected in a relationship where AUD is not an issue. Studies find that marital or domestic relationships with an individual with AUD have a high degree of relationship dissatisfaction and that tension and verbal conflict are usually high.
A partner may assume a relational preoccupation that parallels the individual with AUD’s obsessive preoccupation with alcohol, trying to convince the mate with AUD to discontinue drinking. When this process characterizes the relationship, the sober partner needs encouragement to emotionally abstain from participating in the partner’s destructive behaviors.
Relationship Dynamics
Couple interaction can be significantly affected by AUD and alcohol-related behaviors. Being an individual with AUD requires energy, not for long-term growth but for maintaining short-term stability. The developmental milestones that would be expected in a relationship are identified instead as developmental distortions.
A negative cycle may occur in which the spouse becomes more fearful as the individual increases alcohol use and may then respond with a greater focus on getting the individual with AUD to stop drinking. The individual experiences this through feeling over-scrutinized and pressured. The assumption, relative to the relationship conflict, is that if the drinking stops, the problems will stop. This attempt to manage the behavior of the other further deteriorates the relationship. Behaviors that result from AUD become the primary factors in how the family system functions and is organized. In such cases, partners may lose their sense of direction and identity as they attempt to survive in the high-stress environment and realize that their life has been structured around the individual with AUD.
Under normal circumstances, a marital or domestic relationship exists to meet the basic needs of protection, shelter, and food of family members through a unified process. With heightened tension, such as when one partner is an individual with AUD, changes occur in regulatory behaviors to ensure a relationship that accommodates the demands of AUD. If the partner of the individual with AUD becomes anxious, the anxiety can escalate and spread to all family members. When this happens, the normal emotional connectedness that should be comforting becomes stressful. Eventually, family members begin to feel overwhelmed and out of control.
Family members who feel the greatest stress tend to accommodate others to alleviate familial tension. The person who accommodates the most, usually a spouse but sometimes a child, is attempting to absorb the anxiety present in others. This family member will become the most vulnerable to physical illness and depression or even to AUD.
Relationship Violence
Although excessive use of alcohol has been associated with spouse (mostly wife) abuse, no evidence has found a causal relationship between AUD and family violence. However, factors that add stress to the family are associated with marital and partner violence, and excessive use of alcohol is a stress-producing factor. Conflict between the couple over drinking patterns also increases the potential that violence will be used to manage conflict.
Undesired sexual relations (including rape) may be forced by a partner after drinking. Substantial research shows that physical and sexual aggression in men is intensified by alcohol. A partner who is normally not aggressive can become aggressive or even violent when drinking heavily.
A national study found that the more often a spouse or partner was drunk, the greater the likelihood that physical violence would be a part of the relationship. In cases of extreme drinking by one partner who was almost always drunk, the likelihood of violence dropped to a lower level.
Intervention
Working with spouses and partners of individuals with AUD requires careful exploration. Many people have experienced relationships that are chaotic, unreliable, and emotionally confusing. Often, the feelings of anger and resentment are not expressed for fear of exacerbating the individual's drinking or hindering their recovery. There may be repressed desires and dreams for the future that the sober partner does not voice, such as buying a house or having more time together.
If a couple seeks therapy, and if one partner is a substance abuser, it is likely that the use of alcohol or the impact of alcohol-related behaviors will not be the focus of the relationship problems. This is to be expected because it is estimated that only one in four persons who abuse alcohol will seek treatment for their drinking problems. If the therapist does not demonstrate sensitivity to how AUD affects relationships, the issue may never become a part of treatment. It is generally believed that a combination of approaches, which includes both couples therapy and self-help approaches for AUD, will be necessary. A therapist should always assume the responsibility of helping the couple understand how AUD affects their relationship. Also, the therapist should help the couple understand what precipitates excessive drinking or what leads to a relapse.
Communication by the partner without AUD will sometimes include diagnostic labeling as an attempt to encourage a partner to seek help. Labels such as being an alcoholic or being in denial carry certain stigmas, and it is only reasonable that persons with self-confidence will reject such labels. Relationships may have an underlying dynamic that represents a power struggle and one person’s attempt to assert control. A remark such as, “Your problem is that you are in denial” may seem harmless when it is uttered but tends to be perceived as judgmental.
Therapists using twelve-step programs usually focus on the processes that enable drinking. The goal is to help spouses or partners experience emotional insight and to identify enabling behaviors. Self-help support groups attempt to empower spouses and partners and begin establishing a meaningful and satisfying life, regardless of the partner’s AUD. Regular visits to Alcoholics Anonymous (AA) meetings, which support individuals on their sobriety journey, and Al-Anon family group meetings, which support spouses and other family members of individuals with AUD, have been shown to improve an individual's chance of long-term success and may decrease the chances of divorce or separation. Additionally, addressing underlying or comorbid conditions, such as depression or an anxiety disorder, which occur in around 20 percent of individuals with SUD, is essential for the success of the marriage or partnership.
In general terms, the recovery process consists of three stages—detoxification, rehabilitation, and maintenance. Detoxification should occur under healthcare supervision, often accompanied by benzodiazepines, like Ativan, to help the individual safely detox. Rehabilitation may occur on an inpatient or outpatient basis. Long-term sobriety is an active process that requires the individual in recovery and their partner to continue practices that support sobriety, such as support groups or counseling.
The National Council on Alcoholism and Drug Dependence in New York City provides five guidelines for persons dealing with an individual with AUD. The organization’s advice is to recognize alcoholism as a disease, to learn as much as possible about alcoholism, to avoid becoming an enabler, to avoid home treatments, and to seek professional help for personal development.
Bibliography
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"What Is Alcoholism?" Alcohol Rehab Guide, 17 Nov. 2023, www.alcoholrehabguide.org/alcohol. Accessed 5 Sept. 2024.