Introduction
In the early 1930s, social workers in state hospitals reported their observations of the wives of alcoholic men, describing the wives as having anxiety, depression, and psychosomatic symptoms. The social workers suggested that such psychological symptoms were not caused by living with a chronic alcoholic; instead, the women who displayed such symptoms were using their marriages to alcoholic men to resolve their own neurotic conflicts. Furthermore, it was suggested that if the male alcoholic 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 upon the interactive process between alcoholics and others in close relationship with them.
Alcoholic Spouse/Partner Relationships
Addiction to alcohol is a relationship issue. Being married to or in a domestic partnership with an alcoholic places a strain on that relationship, causing the nonalcoholic partner to take on responsibilities that would not be expected in a nonalcoholic relationship. Studies find that marital or domestic relationships with alcoholics 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 alcoholic’s obsessive preoccupation with alcohol, trying to convince the alcoholic mate to discontinue drinking. When this process characterizes the relationship, the nonalcoholic partner needs encouragement to emotionally abstain from participating in the partner’s alcoholic behavior.
Relationship Dynamics
Couple interaction can be significantly affected by alcoholism and alcohol-related behaviors. Alcoholism 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 alcoholic increases alcohol use, and may then respond with a greater focus on getting the alcoholic to stop drinking. The alcoholic 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. Alcoholic behaviors become the primary factors in how the family system functions and is organized. In such cases, nonalcoholic 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 alcoholic.
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 alcoholic, changes occur in regulatory behaviors to ensure a relationship that accommodates the demands of alcoholism. If the partner of the alcoholic 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 alcoholism.
Relationship Violence
Although excessive use of alcohol has been associated with spouse (mostly wife) abuse, no evidence has found a causal relationship between alcoholism 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 alcoholics 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 alcoholic’s drinking or hindering his or her recovery. There may be repressed desires and dreams for the future that the nonalcoholic 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 alcoholism 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 alcoholism, will be necessary. A therapist should always assume the responsibility of helping the couple understand how alcoholism affects their relationship. Also, the therapist should help the couple understand what precipitates excessive drinking or what leads to a relapse.
Communication by the nonalcoholic partner 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 in 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 to begin the process of establishing a meaningful and satisfying life, regardless of the partner’s alcoholism.
The National Council on Alcoholism and Drug Dependence in New York City provides five guidelines for persons dealing with an alcoholic. 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
Ackerman, R. Perfect Daughters: Adult Daughters of Alcoholics. Deerfield Beach: Health Communications, 2002. Print.
Freeman, Shelley MacKay. Paths to Recovery: Al-Anon’s Steps, Traditions, and Concepts. Virginia Beach: Al-Anon, 1997. Print.
Jay, Jeff, and Debra Jay. Love First. 2nd ed. Center City: Hazelden, 2008. Print.
Smith, Philip H., et al. “Women Ending Marriage to a Problem Drinking Partner Decrease Their Own Risk for Problem Drinking.” Addiction 107.8 (2012): 1453–61. SPORTDiscus with Full Text. Web. 29 Oct. 2015.
Watt, Toni Terling. “Marital and Cohabiting Relationships of Adult Children of Alcoholics.” Journal of Family Issues 23 (2002): 246–65. Print.
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