Sexual coaddicts have greater difficulty managing an illness that, for the most part, can be kept secret and is hard to uncover. Even the recovery is done in secret. There is less social support for the problem in the larger community, and in society. This, too, may be a result of social stigmas that are tied to sexual addiction vs. alcoholism.
Codependency is a disorder that usually has it's roots in deep feelings of shame that arise from child abuse.
Shame is the feeling that you are not good enough, not deserving, inherently worth less than other people, bad, etc. Many people who were shamed in their histories spend much their lives feeling themselves in such a "one down" position to others.
Other people compensate and flip over into feeling arrogant and superior, being needless, denying that they have emotional problems or emotions at all, and assuming a "one up" position with others.
In either case, both adjustments in adult life reflect deep, toxic shame and are the product of abuse.
Both adjustments are dysfunctional.
Either of these orientations disconnects the codependent person from other people, either looking up to or down at others. They are also disconnect from themselves.
The person's emotional, social, and spiritual needs, cannot be met.
The pain of this sort of loneliness combines with the deep wounds of the "core of shame" and often drives the codependent into maladaptive efforts to cope. These efforts may include controlling other people, either ruthlessly or through excessive indulgence and kindness, addictions, emotional deadening, living vicariously through others, and so forth.
Only when codependents come to accurately value themselves as people, meet their own needs and wants openly and appropriately, and repair the boundaries damaged in childhood and later, can they enter recovery from codependency.
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Codependent people have a greater tendency to get involved in relationships with people who are addicts, emotionally unavailable, or needy. The codependent person tries to provide and control everything within the relationship without recognizing their own needs or desires, setting themselves up for continued disappointment and not being self fulfilled.
Controlling behavior
Distrust
Perfectionism
Avoidance of feelings
Relationship and Intimacy problems
Caretaking behavior
Hypervigilance (a heightened awareness for potential threat/danger)
Physical illness related to stress outbursts of rage
http://www.cosa-recovery.org/behaviors.html
The following questions can be used to help you identify unmanageable areas of your life and “bottom line” behaviors. Do you:
Melody Beattie, author of "Codependent No More" - check list:
Ironically, codependency isn't about other people - it's about the relationship with the self. Codependents often believe that if the addict in their life sobered up their problems would go away.
Countless addicts find their relationships end or change radically when they get clean and sober. The family / relationship dynamic was predicated on the addict being "the sick one." As the addict gets well they may find their partners and family members have no idea how to adjust to the changes.
Enabling codependents may subvert the addict's recovery so the unhealthy relationship dynamics can be preserved.
Addicted codependents who hid behind another's more dramatic problem may leave the relationship rather than give up their own using. Addicted codependents often progress in their own addictions more rapidly when their partner enters recovery. (Since the change in the relationship is stressful.)
Codependents in denial cannot adjust to the relationship changes that occur when their partner begins recovery. They may move on to other addictive relationships so they can cling to their own dysfunctional patterns. (The controlling codependent is often lost without someone to blame, fix and control.) How many times have you heard of people who leave one alcoholic only to enter a relationship with another one?
All people involved in the addictive cycle need a solid recovery program if relationships are to be preserved and they are to lead happy, fulfilling lives.
These patterns and characteristics are offered as a tool to aid in self-evaluation. They may be particularly helpful to newcomers.
I have difficulty identifying what I am feeling.
I minimize, alter or deny how I truly feel.
I perceive myself as completely unselfish and dedicated to the well being of others.
I have difficulty making decisions.
I judge everything I think, say or do harshly, as never "good enough."
I am embarrassed to receive recognition and praise or gifts.
I do not ask others to meet my needs or desires.
I value others' approval of my thinking, feelings and behavior over my own.
I do not perceive myself as a lovable or worthwhile person.
I compromise my own values and integrity to avoid rejection or others' anger.
I am very sensitive to how others are feeling and feel the same.
I am extremely loyal, remaining in harmful situations too long.
I value others' opinions and feelings more than my own and am afraid to express differing opinions and feelings of my own.
I put aside my own interests and hobbies in order to do what others want.
I accept sex when I want love.
I believe most other people are incapable of taking care of themselves.
I attempt to convince others of what they "should" think and how they "truly" feel.
I become resentful when others will not let me help them.
I freely offer others advice and directions without being asked.
I lavish gifts and favors on those I care about.
I use sex to gain approval and acceptance.
I have to be "needed" in order to have a relationship with others.
"The irony is that as much as a "codependent" feels responsibility for others and takes care of others, she believes deep down that other people are responsible for her. She blames others for her unhappiness and problems, and feels that it's other people's fault that she's unhappy.
Another irony is that while she feels controlled by people and events, she herself is overly controlling. She is afraid of allowing other people to be who they are and of allowing events to happen naturally. An expert in knowing best how things should turn out and how people should behave, the codependent person tries to control others through threats, coercion, advice giving, helplessness, guilt, manipulation, or domination.
http://www.recovery-man.com/books/codependency.htm
Back From Betrayal , By Jennifer Schneider, Recovery Resources Press
Beyond Codependency , By Melody Beattie, Harper/Hazelden
Boundaries and Relationships , By Charles L. Whitfield, Deerfield Beach
Codependant No More , By Melody Beattie, Harper/Hazelden
The Language of Letting Go, By Melody Beattie
Living with Your Husband's Secret Wars , By Marsha Means, Revell
Love is a Choice , By Robert Hemfelt, Thomas Nelson Publishing
Partner's Healing Journey Workbook , By Marsha Means, Prodigals International
Partner's Recovery Guide , By Douglas Weiss Order from Heart to Heart Counseling Centers P.O. Box 51055 , Colorado Springs, CO 80949
Women Who Love Too Much , By Robin Norwood, Pocket Books
based on "Long Term Treatment of Partners of Sex Addict" by CARA TRIPODI in Sexual Addiction & Compulsivity
The denial system has been shattered and the realization that partner of a sex addict has contributed to the problem by not confronting it.
For years coaddicts blamed themselves for the addict’s unhappiness. This replicates feelings of abandonment from their own upbringing which predisposes them to relationships where they doubt their truth and stay stuck in a system that continues to reinforce this belief.
Partners who knew of the behaviors describe a lack of control over their own lives.
Partners presenting in crisis not overtly knowing or suspecting the addict’s behavior, often report having had a “hunch” that something was not right in the relationship.
A discovery forces a coaddict to confront her belief system and start to recognize that there is a problem and that help is needed. The help is initially often for the addict and for the pain the addict has caused them.
It often takes longer for coaddicts to recognize the role their denial played in keeping the relationship unhealthy. Typically, once treatment advances, differences between those coaddicts who knew of the sexual behaviors and those who were unaware often diminish.
By identifying the coaddict’s compromises, the couple begins to understand the partners’ role and moves them forward in their healing. Early in their treatment, many coaddicts have difficulty identifying with the various labels in the recovery movement (e.g., codependency, dysfunctional family, and sexual addiction).
At this stage, they often will resist labels that apply to them because they hear it as blame for the addict’s behavior, thereby missing opportunities to see their role in the addiction. As stated previously, partners with knowledge of the sexual behaviors, are more apt to present in treatment focusing on their role in abetting the addictive process. They present as informed about addiction and readily apply those labels to themselves. The emotional upheaval and crisis at this stage affects their ability to internalize how labels and themes from childhood apply to them.
It is better to help coaddicts establish emotional stability initially, which will foster their self-confidence and lead to them becoming receptive to learning about the addictive system. Some partners have reported reluctance in seeking treatment for fear of being labeled and therefore possibly misunderstood by therapists. Others have had prior therapeutic experiences where their concerns were minimized or explained away by therapists, and subsequently coaddicts felt blamed for their overreacting tendencies. The sexual problems or concerns were often denied or conceptualized as a “couples” issue. In such instances, the coaddict is doubly victimized, first by the betrayals of the addict and then by the system that intends to help. In addition, many coaddicts are too angry with the addict and will withhold their involvement as a way to express their anger, and as a reaction to the crisis. Initially this can be an appropriate response in some situations, for it can force the addict to face the problem on their own and allow the coaddict to see if the addict’s intentions are sincere. If this stance continues for longer than the first year of treatment, it can be indicative of coaddicts refusing to change and their reluctance in addressing the addiction directly. As partners move through the initial crisis stage and begin to adjust to the addiction, they will respond with a myriad of emotions. Most coaddicts are deeply conflicted about the role they played in the addiction; therefore they are extremely sensitive to being put into a category early on. In fact, many will view their behavior as a reflection of their personality rather than as a component of an addictive relationship. Essentially, the coaddict has denied their needs and wishes in the relationship or they have argued and then felt wrong for wanting certain things from the addict (Schneider, 1988; Carnes, 1991; D. Weiss & DeBusk, 1993). Either way, they subjugated their needs to the addict. In doing so, they learned that their voice in the relationship was not reliable and lost themselves in the process. What often drives partners to seek help are the ongoing struggles they encounter with the addict and their inability to set limits in the relationship. They do not understand how they tolerate the addiction by denying their needs. Through therapy, their understanding of the addiction expands into other aspects of their lives and they actively begin to move from the addict’s problem to their own. PHASES OF RECOVERY Phase One: Shock, Crisis and Information Gathering This is typically the most difficult and painful part of the process for partners. Foremost is the trauma of learning about the addiction, and the resulting emotional upheaval and uncertainty that has now entered their lives. Accepting or calling this an addiction can be extremely shaming and, at the same time, welcomed because now there is name that can be applied to a set of symptoms and circumstances that had seemed previously unknown. Initially, for some, there is extreme anxiety and fears centering on social, economic, and familial security. Questions around sexual boundaries will arise for themselves as well as for their children. Sexually transmitted diseases are a fear and most partners should be encouraged to seek testing: and some partners will demand it of the addict. For those partners with children, there is the worry that the children may have been exposed to the behaviors. Overall, they are concerned about the adverse effects the addiction will have on the family system as a whole. Is the addict’s behavior putting the children at risk? Often addicts use the home computer as a means to view pornography. Some children are unwittingly involved because they may find online pornography while working on the computer. Unfortunately addicts are often not cognizant of the ramifications of their sexual behaviors since part of the disease process is to distort reality and deny or minimize the risks involved in their behavior (Carnes, 1991; R. Weiss, 2005). One partner reported that her ten-year-old daughter, while doing homework, approached the partner’s husband and was exposed to pornographic images of unclothed teens. In another example, a partner reported that she came upon her husband’s emails to his various paramours. After asking to him to leave the family home, she told their teenage boys about the father’s behavior and learned that they had known of this behavior for the last few years. Often coaddicts are less skilled with the computer, and addicts can often have greater freedom and access without the fear of being caught. The children in these families are more educated and knowledgeable about the computer and are at greater risk of being exposed to the sexual material of the addict. Now that computer images can be downloaded to cell phones, addicts are able to access and transport their material more easily. One partner said that it was her five-year-old daughter’s discovery of this material on her husband’s cell phone that motivated her into confronting him and seeking treatment for both of them. In another example, an 11-year-old daughter of a coaddict intercepted a call from her father’s lover and told the mother that she thought the father was having an affair. In this case, the partner had displayed various signs over the years that the coaddict chose to ignore in favor of the spouse’s reasoning and explanations of suspicious events, usually centering on his work schedule. This resulted in children being exposed to matters that, if confronted sooner, would have allowed the children greater protection by the mother. During this stage of the partner’s recovery, coaddicts will begin to seek help for themselves. They enter treatment seeking information, validation, and education about addiction. In treatment, this is often the “how to” for best meeting the needs of the coaddict. All of these skills are important and each should be used consistently, especially the educational piece, for it offers a foundation from which a partner can grow and learn the necessary steps involved in recovery. At this stage in their healing, partners respond best to the directness and advice of the therapist. This is important to note since, for some therapists, this can be extremely uncomfortable and counterintuitive. However, in the treatment of sex addiction, it is imperative to give concrete guidance since much of the disease is centered in faulty or impaired thinking. This can be especially true for the partner who may have, for years, trusted the thinking of the addict more than her own thinking. There is a tremendous amount of self-imposed and, at times, externallyimposed pressure for the coaddict to leave the partnership. Friends and family members who know that the spouse is a sex addict may urge the partner to leave. Often these individuals are misinformed and uneducated about sex addiction and therefore do not believe that healing from the disease is possible. In some instances, the coaddict’s own family of origin provide an unsupportive environment. Coaddicts will attempt any way to seek emotional validation even when it is not possible. This dynamic later becomes an element of their recovery as they each explore the impact of their own childhood and its role on their intimate relationships. One partner disclosed to her brother—a recovering alcoholic—that her spouse, a sex addict, had been cheating on her. Her brother threatened to kill the addict in his shock and outrage over what he had learned. Many partners experience shame and never let their family or friends know about sex addictions. They might make reference to having had problems for which the partnership got help, but they will remain discreet about the reason. Also there are those partners who, as a means of deriving emotional support or as a way to punish the addict, will indiscriminately tell family members. These more immediate reactions can, at times, have implications for the partnership for years to come. One partner’s mother, who never liked the spouse, sent her daughter information about psychopaths. This frightened her and played into her persistent ambivalence. During this time there is tremendous ambivalence toward the addict, which can be extremely painful. Partners are often looking for an escape from the intense emotions that overwhelm them. In therapy, they will question repeatedly whether they should leave the relationship as they experience a significant amount of distress in their quest to come to terms with the upheaval that has now confronted them. They often report feeling lost in their fluctuating feelings for the addict who has betrayed them, and upon whom they have relied. Therefore, it is often the worst time for partners to decide to leave the relationship; instead, making more temporary decisions while they go through this difficult phase is recommended. Some partners have found it necessary to ask the addict to leave the home upon learning of the addiction. Others have found that asking the addict to sleep in a separate bedroom helps create stability and control in a time of extreme stress. One partner found that taking back her maiden name was part of what she needed to gain some emotional separation. Additionally, many have found it necessary to stop sexual contact with the addict for a period of time. Some of these initial changes can be beneficial and help to build some confidence in the partner’s ability to effect change in these untoward circumstances. In the initial phase of treatment, partners often question the past as a way to come to terms with the present. Many question what they may have missed, how they tolerated unacceptable behavior, and how to reconcile the person they thought the addict was before the diagnosis with the person they believe the addict now is. This is a common expression of the grief they experience over the loss of the relationship as they knew it, and they question whether they can stay in the relationship. The ambivalent feelings, although about the addict’s behaviors, are also more significantly about themselves. Without a strong sense of identity and a clear integration of beliefs and values that match actions, it is nearly impossible for these partners to have meaningful goals for themselves or their relationships. Partners are encouraged to be active in their addict’s recovery by establishing clear expectations of their addict’s behaviors. This can be a confusing and threatening prospect for many coaddicts because most have been accustomed to deferring or quieting their wants and needs for fear of being denied, ignored, or promised things that the addict cannot provide. Alternatively, many coaddicts may be able to communicate their needs for change, but often through dysfunctional means. Angry outbursts, reasoning tactics, or overwhelming tears are ways they would express themselves and then became frustrated when their requests were denied or ignored. In recovery coaddicts learn to establish follow-up measures if their requests are not met. This can only be achieved once they have confronted abandonment fears that they may lose the relationship if the addict fails to meet their requests. Coaddicts are not accustomed to setting limits and enforcing consequences, because they do not feel entitled to being heard. Thus, a goal for them is to begin to recognize their needs and to start to express them. This process begins at a time of significant upheaval in the relationship, and continues, through the expression of different needs at later phases of treatment. Partners often need their addicts to commit to a schedule regarding their recovery. Expecting the addict to be in therapy, attend meetings and work with a sponsor are typical requests from coaddicts once they can battle their own internal struggle to not be too controlling. Further needs include more structure in the home. For example, setting time frames for work and responsibilities with the children are common. Moving the computer into a common family area is a typical request. Partners will know they are bothered by the behaviors of the addict but often struggle with their sense of worthiness in asking changes of the addict. Addicts and their partners are enmeshed in an intricate web of dependency. Therefore, it is an important juncture for coaddicts to establish a sense of emotional maturity as they differentiate within the relationship. They learn to trust their intuition better, and when evaluating the addict’s truthfulness, they begin to see the difference between the addict’s actions and their words. In one case, a partner reported that upon learning that her spouse was late to care for their child, she did not want nor care to know the reason for his lateness; she allowed herself to feel her feelings, then made other childcare arrangements without listening to his reasons. She later learned that, in fact, he had overslept and she was right to trust herself and to act on her own behalf, rather than react to his behavior. Throughout the relationship, she had tolerated his lateness and would become a victim to this behavior. Initially in treatment, the coaddict’s sense of victimization by the addict’s sexual behaviors is strong. Having the capacity to understand the difference between a slip and a relapse can be fertile ground for partners to lose balance with themselves and with the addict. They will often over- or underreact to situations since this is unfamiliar territory for them. Coaddicts know they cannot tolerate the sexual behaviors, but reconciling how they need to respond to other violations and disappointments is extremely complicated. Having a secure and reliable system of support allows partners to process their feelings and set the stage for deciding any action or inaction needed. The sexual parameters in the relationship can go through various transformations as the partners address their reactions to the crisis. Many may initially feel this is the only area that has given them satisfaction; others may perceive some sense of control, so will therefore continue to engage without any sense that limits may be needed. In fact, some react by feeling stronger sexual ties to the addict and will feel awakened to an arousal that they have never known before or will be reminiscent of the relationship in earlier times. Phase Two: Normalization of the Reality: Focus Shifts from the Addict to the Self During this time of their recovery, partners begin to experience greater selfconfidence. It is often at this phase that couples begin to confront new challenges together regarding boundary setting and intimacy. Coaddicts begin to be tested in their ability to change, because they are forced to deal with an addict who is in recovery and thus potentially more of an equal partner. Also, this is when the underlying issues stemming from their childhood can be more directly faced. Abandonment, neglect, and themes related to shame and anger are addressed. For instance, many coaddicts who were raised in alcoholic backgrounds are able to openly speak of the impact that drinking has had on their lives. Others are able to identify an absent parent or other traumatic experience(s) that led to a sense of abandonment. Consequently, coping skills developed and became fixed, especially the pattern of caring for others, at the expense of themselves. Sometimes, at this phase of treatment, partners will feel stronger and more able to make the necessary decisions to leave the partnership. They are able to see certain behaviors as “red flags” and confront them effectively, rather than become a victim to the behaviors. They take the information and measure it against the parameters they have established for themselves. An example of this would be a partner expressing a bottom line behavior to the addict (e.g., if the addict has one anonymous encounter, this results in immediate separation). This new behavior demonstrates that the coaddict is able to make a decision and follow through with it. During this stage, the partners are able to identify patterns of the addict and not personalize the addiction; in Phase One, they are less capable of seeing the responsibility of acting out, as that belonging to the addict. When partners decide to terminate relationships with the addicts, and children are involved, the processes of separation and divorce can introduce new traumatic experiences and the initial victimization partners felt in the relationship resurfaces. The stress and subsequent legal decisions can impede the partners’ recovery if their trauma responses are high. One client, who had never had a concern about the addict’s risk to her daughter, began to feel hypersensitive to the idea that he might harm the child sexually once separation and fighting over visitation occurred. The coaddict herself had been a victim of child abuse, and this history combined with the victimization she felt in the marriage, began to cloud her perspective and complicate the divorce process. In addition, her daughter was further caught in the middle and reacted to the mother’s fears. Phase Two is a time when partners are fully engaged in the recovery process. They are actively involved in reading the related literature about addiction and its impact on the family of origin. Reluctantly they start to identify with the concept of an “inner child” recognizing that at an earlier phase of development the younger self was neglected, abused and/or abandoned by the family. Many are resistant to this notion since it reflects experiences where they had little control and needed to fend for themselves. They are often afraid to experience the unpleasant feelings associated with having been a child, since many did not have adequate and consistent caregivers to rely upon. This forces them to confront their own isolation and loneliness, which is why they have partnered with a sex addict with whom they could focus and thereby distract themselves from their own reality. In this phase of their recovery, many partners attend 12-step meetings, individual, and/or group psychotherapy. Peer relationships in recovery start to form as time is shared outside a meeting or group. Others find the 12- step meetings limiting for them, and will have developed a key person or two with whom they can talk freely about the changes that are occurring in their lives. Still others of religious faith may become more involved in their spiritual practices and may join committees or groups to further their involvement. For some, the initial distress symptoms have required intervention of psychotropic medication. Many begin to confront a long-standing history of depression or anxiety that they denied, minimized, and/or normalized for years. Once in treatment, they acknowledge the existence of these diagnoses and take a more active role in managing them. Feeling more in control of themselves, they can more readily question the codependency traits in their relationships. Sexual boundaries are often more directly addressed at this stage. Many prior limits were often in reaction to a crisis, but in Phase Two, partners take a more active role in confronting their relationships in recovery. Many will report disturbing and intrusive thoughts of the addict’s addiction while being sexual, which creates tension for them and can trigger the need to withdraw, and avoiding sexual contact until there is more safety. Phase Three: Advanced Recovery Issues Addressed In Phase Three, coaddicts have now entered a period of further integration about the meaning of addiction in their lives, and the impact their own upbringing had on their feelings of safety and security in the world. Partners openly explore the causes and implications of being raised in environments where their needs were made unimportant. Partners report experiencing calm and peace and a greater appreciation for the people in their lives. One partner, after five years, reported she could finally receive the good intentions and feelings her two closest peers had for her. She “knew” they cared for her, but it was only through her work on herself, especially on the themes regarding abandonment and survival strategies she used to defend against feelings, that she allowed herself to integrate this knowledge with her felt experience. There is less focus now on the sexual addiction and especially the details of the addict’s behaviors. There is greater availability to other areas of the coaddict’s life and it may be at this time that they become involved with new professional or personal endeavors. One partner who had been a stayat- home mom with only a high school degree found tremendous satisfaction when she was offered a part-time job in a local school offering foreign language classes to students. This validated her self-worth and demonstrated her ability to have a separate identity from the partnership. She continued to also become more deeply involved in her religious group, where she experienced tremendous support. After five years, she knew that she was ready to leave treatment because she found her life had taken on new meaning and that she was able to more effectively handle problems that arose. Another partner had delayed going back to school for a master’s degree because she had felt preoccupied emotionally by her recovery for four years. When the opportunity presented itself again, the timing was perfect, and she felt up to the challenge. Intimacy within the partnership is more deeply explored. Each becomes aware of the other’s role in the distancing that has existed, and are actively engaged in a process where they can try new behaviors. Workshops geared to intimacy, couples therapy, and retreats help to develop intimacy. These are often the safe and structured types of settings in which to try out new approaches together. One couple in recovery found that their attendance at a weekly 12-step meeting for couples became something they looked forward to for the strength and support they felt from the meeting process. The addiction has been a catalyst for change, and with recovery, coaddicts and addicts alike become more open to seeing the role their own backgrounds have played in forming and maintaining the relationship, as they knew it. There is an appreciation for what addiction has brought to their lives, and they report feeling more detached from the earlier expressions of pain with which they initially presented. But this also is a period where many sex coaddicts explore more deeply those areas of their past that for years they denied as problematic. For some, it is addressing the shame of being raised in an abusive environment. For others, it is the repression of child abuse memories that can only now be acknowledged after years of therapy. For another, it is the safety of being in group psychotherapy with other coaddicts so she can face the fears about wanting a child, and yet address her resistance to having one because of being raised in an alcoholic family. For yet another, it is moving away from the addiction model of treatment, discontinuing 12-step meetings and being ready to leave therapy to embrace a spiritual practice that better meets her needs and indicates advanced recovery. Ultimately, partners at this phase are more in charge of their treatment progress. They feel more directed in their treatment goals and their self-worth has increased. They experience less self-doubt about decisions and when they do are more open to seeking help and input from others. INTERVENTION TECHNIQUES Long-term issues in working with partners of sex addicts are both unique and challenging. Therapists have many opportunities to help partners confront and heal, and change from a complex and highly shaming pattern of behavior that impacts most facets of their lives. A myth often voiced about the coaddict is that they either hinder the addict’s recovery or are unwilling to engage in the recovery process. In fact, partners are an integral part of the addicts’ healing. Their involvement can be associated with better treatment compliance and outcome of recovery of the addict. While the clinical work can be rewarding, it requires that the therapy be flexible and, at the same time, mindful of the processes of both denial and recovery. Brown and Lewis (1999, p. 9) noted, “The therapist is always guided by a focus on the organizing principles of loss of control, abstinence and the long-term developmental process.” It is advisable to enlist peer support and stay informed about current treatment modalities for coaddicts. This helps in building competence and limiting the countertransference that can occur with partners of sex addicts. Initially, it is essential that the first phase of treatment address and normalize the shock and disorientation that results from the discovery of the addiction. Education will teach about boundaries and how to establish them in the relationship where the partner often felt little control. Engaging the intellect, while prompting emotional insights with examples of current stressors in partners’ lives, can help expedite openness to change and foster trust in the therapeutic relationship. Recommending lecture series or psychotherapy groups geared to partners’ issues is tremendously useful at this stage. Referral to 12-step meetings also is extremely helpful. Clear and direct guidance from the therapist is strongly encouraged since many partners are floundering in their confusion and self-doubt and look to the therapist for emotional grounding. Remember that partners have great difficulty with change and will need constant reminders of the helpful options available to them. Do not be surprised if a partner is reluctant to go to a meeting; for some it can take months to attend their first one. The degree of internal pain and possible external consequences (loss of income to the family, law enforcement involvement) for coaddicts, as a result of the addict’s behaviors, cannot be minimized. This can be an extremely uncomfortable place for therapists since they would like to support the partner in getting involved in the changes necessary for recovery to hold. Balancing the pace of the partners’ progress, and at the same time prompting change by pointing out cognitive distortions and setbacks in their progress, is a useful strategy in working with this special population. Change comes slowly; the patterns developed happened slowly. Giving reminders of the context of this developmental process helps normalize the understandable impatience partners and therapists can experience in the treatment. During Phase One and Phase Two of treatment, therapists can notice partners’ increased insight about their feelings and the profound self-doubt manifested through second-guessing, minimizing, and/or denying their reality. They have become accustomed to trusting the addict’s views over their own. In one case a partner found that when she would question her husband’s patterns of acting out with men over the years, he would compare his inability to stop his behaviors to her compulsive overeating, thereby quieting her inquiries. She would then blame herself for the sexual and emotional problems in the relationship, and not confront him or hold him accountable. In this instance, the therapist’s reframing of the problem showed how the initial behaviors of the addict would go unaddressed and the partner in turn would take on responsibility that was not hers to take. Furthermore, themes of emotional belittling became apparent, allowing the partner to further see the impact of the addiction on her psyche. It is essential that therapists be mindful that coaddicts do not present alike. In addition to the differences in either knowing about behaviors or not, their own disposition plays a role in how they will advance in their recovery. Some can present with an Axis I diagnosis (e.g. anxiety, depression and PTSD), and some have personality disorders that can impede the process. Finally, previous adaptive coping skills such as religion, spirituality, career satisfaction, and family and peer support are integral in both ongoing assessment and treatment of the partners. Coaddicts initially may present with some of these symptoms, but it is important to differentiate traumatic reactions to the crisis versus other Axis I or II diagnosis that have been dormant and activated by the addiction. One client reports now, after three years of recovery, that she can see that she has been depressed since being a child. Some partners can be more challenging to treat if they demonstrate a higher level of tolerance for unacceptable behavior. Their responses to the acting-out patterns of their addicts can often present as delayed or overreactive. These defensive styles have interfered with them knowing how to establish and enforce appropriate boundaries for themselves. This high tolerance can reflect a more pronounced traumatic and/or negating childhood, which has been ignored or denied by them until this point. The challenge is to confront the unknown of new behaviors, which is terrifying for partners. During Phase Two, therapists will find that teaching partners to regulate their responses to issues that confront them in recovery is an excellent tool in their healing. Sometimes giving them permission simply to collect data that makes them suspicious about the addict’s behaviors allows them to build skills in trusting their intuition while delaying action. This helps foster a sense of internal control of their feelings while, at the same time, teaching them that it is okay to feel feelings without acting, which conversely gives them time to decide what to do. Many partners during this phase will make a number of missteps as they attempt to gain emotional footing. Offering them support while guiding them in reviewing their actions helps partners develop compassion for themselves. Additionally, these are opportunities to draw parallels between historical data from their past to their current situations. Longer-term interventions focus more on the themes from childhood that influenced the types of relationships partners seek. Helping partners see parallels in their behaviors in the relationship to the addict to coping skills as a child provides a broader understanding of how they became oriented to relationships like that of an addict. This may be a time for partners from more destructive backgrounds to move further into those old traumas and they may, in fact, need more therapy.
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