I recently taught a class for Dr. Ellyn Bader in her online couples training program on working with alcoholic/addicts on developing their emotional sobriety. I want to share some of the highlights of that class with you here.

Addicts by nature can be described as self-absorbed and emotionally immature. Getting a clear picture of the onset of their use can tell you a lot about their emotional development.  Increasing developmental capacities for relational success will move them along the emotional sobriety continuum.

What is Emotional Sobriety? 

Most people don’t know that the term “emotional sobriety” was first coined by Bill W., the co-founder of Alcoholics Anonymous. In the early ’50s, after close to 20 years of working with alcoholics, he saw that like himself, many of these (mostly) men and women needed to continue their growth beyond abstinence. 

Emotional sobriety can be defined as:

“The ability to know what you are feeling. The ability to experience your feelings deeply without becoming overwhelmed by them. The ability to regulate your mood without the use of substances or unhealthy behavior.” _{(Tian Dayton, Emotional Sobriety: From Relationship Trauma to Resiliency & Balance)}

I also believe that the process of emotional healing from addiction is a continuum of growth that includes:

• Living your best life
• Being purpose-driven
• Becoming ‘happy, joyous and free’

As a therapist, you can be more effective when working with addicted partners when you address the emotional areas of growth that are most prominent and necessary for emotional health.

Barriers if Partner(s) are in Active Addiction:

1. Preoccupation(with their drug of choice): It makes focusing on the primacy of their attachment relationship with their spouse/partner unlikely if not impossible. The primary attachment is to their drug of choice.
2. Impaired control: It’s difficult to build trust and count on a partner who has difficulty managing their own life. This unmanageability includes their emotions, their thoughts, and their behaviors.
3. Persistent use/relapse/ uncontrollable urges: This creates a crazy-making roller-coaster ride for both partners, who hold out hope only to come crashing down with the next relapse.  Partners orientate around the addiction and walk on eggshells attempting to avoid triggering the next catastrophe.
4. Dissatisfaction, irritability, delusional: There is generalized negativity that accompanies addiction. It is a classic glass ‘half empty’ worldview. The delusional aspect of addiction means that often the addict refuses to join in the reality of those around him or her. They hold out that ‘things aren’t that bad’ and believe that others are overreacting.

Yet, even if they have stopped, these and other underlying emotional deficits can persist.  When helping a couple to repair their relationship in the aftermath of addiction, there is much you can do to target your interventions with each partner based on knowledge of their emotional deficits.

If one or both partners are still active with their drug of choice, then it slows down the couples’ emotional growth. That’s why it’s essential to keep the issue of an untreated addiction ‘on the table’ and educate both partners about how it contributes to their lack of progress.

Interventions for Greater Emotional Sobriety:

1. Confront ‘switching’ addictions & all compulsive behaviours. 

Because addicts’ brains are wired towards seeking a ‘fix’, they tend to be compulsive in a lot of ways. Some will stop drinking, but start gambling, or stop drugging but start masturbating. Some choices, like workaholism, is often sanctioned and overlooked in our culture. Don’t be fooled – it is as big an issue as any other. Some serious behaviours are never reported to you and go under the radar. Be sure to ask the right questions because all addictions are emotionally destructive to the relationship.

One client came to therapy with a gambling addiction. He had spent money he didn’t have and borrowed from family members.  His wife gave him an ultimatum to get help or she was leaving. I later discovered that he also spent around 15-20 hours a week playing video games.  On top of that, he had a high-level job demanding 50-60 hours a week. Even though he insisted it was not a problem, I helped him understand that being a husband and father who could be relied upon, meant him being available to them, both physically and emotionally. His ‘checking out’ with video games had to stop.

2. Confront the negative projections onto their partner:

Along with an addict’s tendency to black & white thinking, his negative mindset means emotions are often “all or nothing”. An unwillingness to take ownership of painful internal states leads him to project blame onto his partner. Help him to acknowledge painful feelings, especially those connected with early life trauma.  At the same time, point out his emotional extremes as an integral part of his addiction. Working to expand his ‘window of tolerance’ means he can learn the necessary task of emotional regulation and self-soothing which brings to an end the emotional roller coaster for both partners.

Another client reported that after a routine fight with his partner, he couldn’t recover emotionally. He felt “hopeless…like there is no point to life anymore”.These types of responses ought to be a big red flag for therapists who can then address them as part of the bigger issue of emotional sobriety.

3. Confront oppositional behaviours that undermine the therapy.

There is a saying in the recovery community: “you can tell an alcoholic; you just can’t tell her much”. Don’t be sidelined when your client pushes away your attempts to point out how their emotional immaturity is showing up in their marriage. This denial often extends to their family of origin trauma as they cling to a fantasy of a loving childhood they never had.  As sad as that is, and as much as the healing of such trauma has to occur, communicate to them that you see through their attempts to escape the truth. 

One male client had grown up with two alcoholic parents. While having everything materially, he was not only neglected but shamed and belittled by his father. He refused to see how his upbringing was showing up in his current marriage, where he made unrealistic demands on his partner to give him the emotional validation he never received at home.

He was very angry when I said to him one day, “your father was a child abuser”.  After much back and forth, he finally let the truth sink in and it had a life-changing effect on him. He no longer needed to deny the past to tolerate the present. He no longer found it necessary to project his unresolved rage on his partner.

4. Repeatedly model and encourage compassion as the key to emotional sobriety.

Self-loathing resides at the core of the addict (and many other clients we see as well). It is the root cause behind their relapses and their lack of emotional progress in therapy. Helping them to acknowledge both the pain of their past and the pain they caused during their addiction is necessary for emotional sobriety. At the same time, they must begin to find self-forgiveness for it all. This gentle acceptance along with a commitment to being a better version of themselves is at the heart of emotional sobriety.

Conclusion:  Confrontation is Your Ally

This population of clients can be extremely challenging to work with. At the same time, they can be some of the most intelligent, accomplished and caring people you will ever meet. Our job is to keep them to task on those emotional deficits that trip them up every time – particularly when they are operating unconsciously.

While we must confront the emotional issues that keep them stuck in the cycle of addiction, it is equally important that they perceive that we care. Your relationship with them needs to be free from any collusion with their addiction or you are sunk. An addict is proficient in detecting when they are up against someone they can walk all over. They need to know you get them and will put their survival over your need to be liked by them. Show them you will continually and lovingly confront them with the truth. They will not be able to be honest with themselves if you do not model high-level honesty in your interactions with them.

I will have more to say on this topic in my next blog.

Here’s to learning and strengthening our ability to provide effective couples therapy to partners with addiction.

Respectfully,

Are you afraid of hard work?

Not your own hard work. Your clients’.

Did you know the only way partners can expect meaningful change in their relationship is if they commit to ongoing strenuous effort?

If not, you are not alone. As crazy as it sounds, so many therapists end up working harder than their clients do.

If you want tips for keeping couples motivated, read on…as what I’m about to share will create a lot of relief for you and help you get better results.

In my last blog to you, “Get Couples Therapy on Track and Moving: What most Therapists Don’t Know”, I quoted Dr. Peter Pearson. With his wealth of experience working with couples over the last 30 years, he has fine-tuned his approach and is a true Master in the field of couples therapy. He is someone I continue to learn so much from.

I emphasized the two most important messages to hit home with couples is to: a) help them learn to calm their reptilian brain (which is triggered by their partner and reacts badly; and b) to stay ‘forward focused’ in their work with you.

Those two things are hard enough to accomplish. But here’s the kicker. If clients do not know their “why”, then as Dr. Pete says, “they will inevitably lose their way”.  So you have to start here.

First Things First

The fact is this: your attempts to get couples to follow through on your interventions will fall flat, if you haven’t first established their motivation to do the hard work of change.

We’ve all been there – wanting their lives to be better more than they seem to.  The therapy stalls, you have premature dropouts, you start to feel burned out and dread sessions with them or worst of all, angry escalations targeted at you for not changing them fast enough.

Like physicians presented with symptoms, they often want the magic pill,  putting the burden of responsibility for relief square on your shoulders. That’s a recipe for disaster, if partners are ever going to move from a place of dependency and despondency to one of authority and action.  

When you insist on pushing couples to connect to, articulate and commit to their personal process of change, your authority as an effective leader will be established. You will have created the structure necessary to keep them motivated and working.

Two Key Strategies to Shift the Workload

1. Ask each partner to think deeply about their purpose for coming to see you. You are not asking for a pat answer, but a deeply meaningful one. “I want to learn how to become a man my wife can trust and count on,” verses, “To get her off my back.”  Or, “I want to learn how to treat him with respect and be more loving,” rather than, “Find a way to get him to help more with the chores.”

2. Next, ask each partner to describe what it will require of them to bring that change about.  Again, you are not settling for a superficial response about some insignificant action they can take, like “I’ll come home on time for dinner each night”. That probably won’t cut it. It might sound more like, “I need to figure out why I lie to him and cause him so much pain. It will mean me healing the damage of my past.”

Once you have clearly established each partners purpose or deep desire and what exactly they are working on as their growth edge, then ask them to describe the benefits that will result – for themselves and their partner.

Spend time here.  Get them to list as many as they can and add a few yourself that they may have forgotten. This is where the Developmental Model incorporates neuroscience findings. This is the way you anchor it in memory and help them to create new neural pathways.

Have them imagine themselves already there. How do they see themselves reacting, how does it feel, what happens for their partner when they act from their highest self? Have them ascribe a word or phrase to this state and write this down on an index card. Ask that they can carry it with them as a reminder of how they aspire to be when they are triggered by their partner.

Forward Focused

Let them know you will support them to maintain this goal by stepping in each and every time they lose sight of or connection to their personal goal.

You will offer them developmental assists and teach them the necessary skills to stay committed to their ‘why’ – so they won’t lose their way. 

You are modelling the futility of rehashing the past and instead replacing it with the personal gift of showing up as their best self.

By following this formula, you will accomplish what many couples therapist fail to do – place the onus of hard work and perseverance squarely where it needs to be – on those that need to change.

All the best,