Couples Therapy with Addiction: What You Need to Know First

All right guys, today we're going to talk about couples counseling. We're going to talk about the risk of it, what's actually happening when you're in the room, and at the end of this I'm going to give you 3 tips on what to do if you find yourself kind of in a sketchy situation. That could either be in a couples counseling room or that could just be at home fighting with your loved one or in any kind of altercation with them. So the first thing I want to talk about is let's talk about the risks of couples counseling. Yeah. So, when it comes to couples counseling, there's— you guys have heard us all say many times that we don't recommend couples counseling when there's active addiction going on. And so today I'm going to explain why, both from a just kind of a what you can see state and then also what's actually happening in the brain state. So first of all, couples counseling can be a bad idea with addiction in the fact that it can make your relationship go down. It can actually deteriorate the relationship. You can have a professional validating the wrong thing, an unhelpful thing. You can have what happens in couples counseling weaponized, and this happens many, many times. You can— you guys can see me looking at my notes. You can be pushed into the bad guy role on an accident. And remember, the bad guy role is really just another way of deflection. And so when we're pushed into the bad guy role, this deflection becomes what the person focuses on instead of the addiction. So when you're in couples counseling, if the therapist validates something that is not helpful, then that often becomes validated at home. And then this, And then this bad guy role kind of gets thrown around a lot. So this could either be the therapist goes in the bad guy role or you get thrown into the bad guy role. So what— so why this happens, and this is the part, this is the meat and potatoes of this video. This is what's so important about this. So I'm going to break stress down into 2 different categories, and I promise I'll loop it all back in so that it makes sense. But when we look at stress, think about stress as coming in in 2 different categories. One is actually called you stress. And eustress is good stress. This is a stress that, that grows. This makes us grow. This motivates us. So this might be if you start exercising, there's stress on the body. If you're learning a new language, this— it's hard, but you're, you're growing. If you're solving some kind of problem with landscaping or whatever it might be, this is, this is good stress. This is pressure that helps us grow as humans. The other kind of stress is distress. So distress, we're going to break this down into 2 more categories. With distress, we have— we can either go ahead and do— sorry, Bree was waving at me, I got distracted. So distress is— we can have it coming in as a way of chronic stress or acute stress. And so with acute stress, what this means is it comes and it goes. So a car accident would be acute stress, having to give a presentation would be acute stress. So this comes into our bodies, our body processes it, and then it moves out of our body and our brain, our central nervous system, all of our body biological working parts, they go back to a baseline of homeostasis, which just means balance. With chronic stress, this doesn't happen. So with chronic stress, what happens is it's, it's like a layering effect. The stress comes in and it just sits and it piles and it sits and it piles and it changes the way our brain works. It changes the way we interact with other people and with ourselves and with our environment. So when we're in a chronic state chronically, then a chronic state of stress chronically, then we look at the world differently. And so what this means is we are more agitated, we're more ready to fight, we're more protective, we're more defensive, we're less humorous, we're less curious, we're less playful, and our brain really isn't in a state of learning or connection. So if we couple all of these things together, and we all know if you're living with someone that struggles with active addiction, or if you are in active addiction, This is a state of chronic stress. And so remember what I said before about stress? We have eustress, which is the good stress. This pushes us to grow. Then we have distress. Acute stress comes and goes. Boom, the event happened, my body processed it, I'm moving on. Yes, that was a terrible thing, but moving on, no big deal. Chronic stress is different. So when we're— when we are face to face with addiction on all of our days and we wake up, we're in a state of chronic stress. So So now let's put this in with couples therapy. So couples therapy in itself is a stressful event. And so naturally, anyone that goes into a couples therapy room, as soon as you walk in the room, unless you're pretty familiar with the whole process, it's stressful. It, it, your brain goes up, your central nervous system kind of goes into fight or flight. How's this going to go? And so I want you guys to think about though, if you're in couples therapy with someone in active addiction, We have 2 competing goals. One, we have the using partner's goal, and their goal, unfortunately, is to keep using if they're in active addiction. Even if they don't wanna use, their brain is wired to be able to say, my number one relationship is with my substance, so I am going to do what I need to do to keep that relationship alive. I'll placate, I'll lie, I'll manipulate, I'll do what I need to do. But really, the addicts, unfortunately, the way their brain is wired when they're in active addiction is their number one goal is to keep this relationship with their substance very much alive. The partner's number one goal is to make that relationship with the substance gone. Because remember what I said about chronic stress? When we're in chronic stress, we're scanning for danger and we're more likely to fight because we are in this survival stance. So anything that threatens your survival, you're going to notice it like that versus if you're not in chronic stress, you're not gonna notice it as quickly. So you walk into a couples therapy room and chances of you fighting are very, very high. Because what happens is the using partner, they want to keep using, and so they want to deflect. They want to be able to justify why, yes, we have a problem in our marriage, but it's not necessarily because of my use. It's because you're crazy. You nag too much. You're emotional. You don't know all the good things I do. And so you can hear that deflection, that blaming. The non-using partner is going to, yes, I only do that because, or you do this. So now we end up in this, in this very heated, charged chronic stress, chronic stress situation, and we have people fighting. So with the couples therapist in this moment, they have too much to handle at this moment. So what's going to happen is that the couples therapist is only going to be focusing on regulation. And regulation is just a clinical term that basically says your brain is in balance. You have control of your emotions. That's all it means. When we're living in chronic stress, we typically are dysregulated. So we go into couples therapy, both partners typically very dysregulated. And so then what happens from the therapist standpoint is they're trying really hard to regulate both of you guys at the same time. And remember what I said before, you have competing— you have competing goals. The using partner wants, unfortunately, to keep the use going. You as the partner want the use to go away. So we walked in with very, very competing goals. So the couples therapist is trying to validate You and you and keep the regulation down and also trying to be able to facilitate change. You can see how this would be a recipe for disaster. And so this is why couples therapy typically doesn't work when we're dealing with addiction. So I do want to go ahead and talk about when it does work. When it does work is when we start to see humility, when we start to see willingness, when we start to see regulation, when either couple, both members can say, yeah, okay, I can get in control of my emotions. At that point, couples therapy could be helpful, but without those skills, it really is just— it's a recipe for deflection. It's a recipe for, we tried that, but it didn't work. Counseling is terrible. Why would I go to— excuse me— why would I go to a professional when what we did last time was just horrible? So you can see how it can then be used as, again, a deflection or why therapy wouldn't work. So I don't want to leave you guys with just the terrible, horrible things. I do want to be able to give you kind of a Quick little 3 tips. So if you find yourself in a couples therapy session and it's going poorly, or if you find yourself interacting with your partner and it's going poorly, I want you to remember the acronym. I wrote it out here so I don't forget, but I want you to remember the acronym of WFP. The W stands for watch your pulse. And so a lot of people wear a smartwatch. This is great in this situation, but watch your pulse. If your pulse gets above 100, Chances are you're dysregulated. So if you notice that this is starting to get above 100, stop talking, pull back. You're dysregulated. That central nervous system, that fight, flight, freeze, it's starting to come in. And which then brings us to the next thing, which is the F. Focus on yourself. Because when we are in a state of chronic stress, we fight. We typically fight, we withdraw. But what happens there is we fight at the target in front of us, which is typically our partner. Especially if we're the non-using spouse and they're using, we fight, we attack. And from the using standpoint, what they do is they fight us because we are standing in the way of their use. So again, WFP. The P stands for process. Process what has happened. Don't process the details. Don't process the events. Don't process the fight. You'll get right back in the beginning. Process the process. Hey, I noticed I became really reactive. When, you know, when that thing was said about my mom, I'm sorry, I'm going to take a break. So you can hear that process on the processing, not why did you say that about my mom, I can't believe you said that, my mom loves you, that was horrible, you're such a— it's so hard to fight with you. So you can hear on the difference there, I'm going to process the process. So if you get stuck, I want you to remember that WFP: watch your pulse, focus on yourself, and process the process. So that's kind of just the Quick little why couples therapy can be pretty risky and it can go south really fast. And the brain, the brain is behind all of this because that chronic state of stress, it's, it's a hard, hard, hard place to be. All right, so that's— you guys have any questions on the topic or anything else? Let's see, um, what about when they're in recovery and out of an inpatient treatment? So would that mean for couples therapy, like, what about when they're— when they are in recovery? Yes, when they're in recovery. That's a good question, Jess, if I'm understanding it correctly. When they're in recovery, we should be able to hear, see that humility and that willingness and that self-regulation. Then couples therapy can be really helpful. But remember, with addiction— and I didn't say this before, but I'm glad you asked that question because it sparked, sparked it— when someone's in active addiction, their ability to handle an intense situation is Very, very low. So when someone's in early recovery, they're still— it's like a muscle that they're redeveloping, they're restrengthening. So with couples therapy, when someone's in early recovery, not through detox, not actually using, and they have a decent amount of clean time— and I would say anywhere from like 3 to 6 months— and they have— and they're showing these regulation skills, then couples therapy can be really good. And this is where, again, I really want you to focus on those last 3 tips. Watch your pulse. Focus on yourself and process the process if it starts to go poorly. Let's see. This is, oh my, I'm sorry, my— I can't read very well without my glasses. Is in residential rehab and he's talking about family counseling with everybody but me. Is that placating? Is that a deflection? That's— do we have more on that? I, I mean, I could see, I could see the motivation for this being that he's kind of saying the saying, he's, he's doing what he needs to do, but he's not— he's either afraid to bring it up with you or he doesn't really want to do it with you. But I would ask more clarifying questions. I would just say, hey, what is this? You know, what do you want to do? I've heard this, but you haven't brought it up to me. Am I dealing with a six-month sober? I am dealing with a six-month sober spouse. We have good sessions, but I don't see that the work being done once we leave the therapist's office. Zero. Yeah. Zero communication skills. Very frustrating. With this, Mimi, I would bring this up in session. I would start. I would bring it up. You know, you're gonna walk into session. The therapist is gonna say, "Hey, how's it going? How's everything doing?" You know, and. The therapist may even say, you know, have you guys worked on the things we talked about last week? Let the therapist do whatever, and then you come in really curious and concise and just say, hey, I think the sessions seem to be going well. I appreciate the communication piece. I'm just— it doesn't seem like we— and use the we language— it doesn't seem like we're really kind of weaving this into our daily life. Can you help us with that? Can you help us figure out how to take what we're learning in the room? Outside the room because you can hear the humility in that. And you— and then at this point, you've let the therapist know without telling on your spouse what's happening outside the room. And at this point, the therapist will probably tell you what to do, give you tips. And then next time you see the therapist, they will most likely follow up on, hey, did that work? And then you can say, actually, no, it didn't work. We still seem to be struggling with that. I'm doing blah, blah, blah, blah, blah. It seems like whenever I do this at home, he or she shuts down, or however that might work. So So you can hear on this, we're playing the long game, but it does open the door for you to be able to really talk about what's happening outside the room in the room. And by the room, I mean the couple session. Um, in jail, acting like the victim, withdrawing, withdrawing in jail. It's been 2 weeks. Okay. How do I maintain my boundaries verbally without invoking anger? On that one, I think less is more. I also think being able to be clear and concise, and so just being able to say, Hey, you know this. I'm hoping I would just say whatever you're trying to say really quickly. If if they start to pick a fight, then I would just say, hey, I was hoping that this could be a more productive conversation. I don't want to fight with you today. I know we both have a lot of stuff going on. I'll talk to you later, and then end the conversation because you can with that anger. That's just you can feel that dysregulation starting to happen. And my guess is if you're wearing any kind of smartwatch or even if you put a pulse on. pulsometer on your finger, you'll notice your pulse is probably going above 100. I've had the backfire of therapy sessions with my alcohol husband. He either, either lashes out or shuts down and says nothing. How do you suggest having any constructive conversation with them? Superficial is all I get. If in this I would— if this is happening in session, if it's backfiring and he's shutting down and you guys are actively In couples therapy, I would stop going because he's building a— he could be building a case for why it won't work and why therapists can't be helpful or why he won't be willing to go back. So what I would do on that, if you're still in therapy, I would just say, hey, you know what, we both have the common ground of trying to make things better between us. Therapy doesn't really seem to be working right now. So I would like to take a break and then just kind of see if maybe, maybe another time would be better, because that's superficial. That, that's harming, that's harming you, and that's harming the relationship itself. If this is something that's happened in the past, then I would just let it lie until you start to see some more willingness on, on your partner's part. The other thing I want to throw in there, just to, just randomly, Males in the culture that we live in, most males, not all males, but most males learn from a very, very early age that it's only okay to feel and express 3 emotions. One of them isn't even an emotion, but it's I'm okay, I'm happy, or I'm pissed off. And so with couples therapy, a lot of times we're pushing on different emotions when we're dealing with a heterosexual relationship. And so there are these push, you know, what, what are the feelings? What's bigger than that? And so pissed off comes in a lot when it's disappointment or shame or sadness or regret or remorse or confusion or just, you know, deep, deep, deep depression or any of that, it comes off in pissed off. And when I can't be pissed off anymore because I'm just tired and fatigued, then we typically end up with this shutdown. Or we end up with the shutdown as the shield because I'm so whatever these other emotions are that I just described that if I'm not shut down, I flip to pissed off and pissed off adds to More fights, so I just shut down. So to me, that sounds like there's a lot of a lot of shields being thrown up there, and couples therapy is not the place to deal with a shield. Individual therapy is where you want to deal with that shield. This is from Julie. Is it is it a good idea to attempt to get court ordered guardianship for an adult homeless son unable to care for himself? Yeah. If you can get that for someone that is unable to care for themselves because they really truly need a guardian, then I would say, yeah, that is helpful. It's hard to get. If it's a form of they are able to care for themselves, they're just not because of active addiction, then I don't think the guardianship would be a good idea. I think it would backfire pretty quickly. This is from P. Shea. If we can't go for couples therapy, how can I improve my relationship with my alcoholic hubby? Thanks. Great question. So what you'd want to do if you can't do the couples therapy is you— and if you're not ready, and I'm certainly not saying don't go to couples therapy, I'm just saying go when you're ready. Go when the environment allows, when you hear that humility, that willingness, and really even before the humility and the willingness, the ability to regulate their emotions. So if you don't have the ability to regulate your emotions or the partner doesn't have the ability to regulate the emotions, Then you don't want to walk into a couples therapist's room. So in this situation, what you'd want to do is you'd want to do your own work. If your partner isn't doing their own work, then as you start to approach things differently, you will change the environment of the relationship. If they're picking fights, you don't take the bait. If they're withdrawing, you make a process comment. If, you know, whatever's happening there, you can come towards them, and if they're not coming back towards you, then you, you can even say, I'm— I'm done. I'm really confused. Like, I'm not quite sure what to do. I'm trying to do this and I'm trying to do that. And it just doesn't seem to be working. I'd be really curious to know what would be good for you and how you could think we could improve this. Don't expect an answer because really what this is, is it's part of the process where you're starting to wake their brain up to start to say, yeah, maybe I do want to make things different and better. And so if you can make some of these strategic process comments, you may be able to kind of move them more towards, yes, I do want to start to work on the relationship. But I would say the simple answer of that is start to work on yourself. Remember that the second one of those tips, focus on yourself. It's natural for us to want to focus on our partners because remember that chronic stress, when we go into that survival mode, we attack those that we think are threatening us. And so if our partners aren't doing the relationship work, that feels like a threat. If they are in active addiction and doing dangerous things, it feels like a threat. So we fight them, we attack them, which pushes them further away from us and further away from the relationship. So we want to focus on us and we want to change the way we interact with ourselves and the relationship. Elizabeth, he wants to come home using an ankle bracelet, but I am too afraid. How do I tell him I won't accept him coming home? Good boundary. If, if you're fearful, your, your brain is going to be in a constant state of dysregulation, and that's not going to be helpful for you or him. So I would be really clear and kind and just say, I love the fact that you want to come home. I'm looking forward to that day. This isn't the time for me because I, I, I'm just not in a place where I think that I'm going to be able to show up in the way that I want to show up. It makes me scared to have you come home at this point. And then watch what he does. And this is, this is important. I say this a lot to my, to my clients. Say whatever you're going to say, do whatever you're going to do, and then stop talking and watch. Because if they're, if they're emotionally manipulating you, if they're being angry, if they're throwing a temper tantrum, this is information that you need to hear because you know that they're not in a state where they can regulate their emotions. And a regulated state is contagious. I don't care who you are, if you sit in a room long enough with someone that's dysregulated, you will become dysregulated. So I, I think that's a good question. I think it's good self-awareness that you can recognize, I don't want him to do this because I don't like the way I feel about it. This sounds to me the wiser choice is to go for individual therapy, not couples. Absolutely. When we're dealing with someone in active addiction or even newly, newly in recovery, Individual therapy is by far the superior choice in the beginning, and sometimes for a long time until we can then move into couples therapy if that's still needed. And sometimes I find people going to couples therapy, either they've already started it by the time they come to me, or they don't want to let it go for whatever reason because it is helping in some way. So what I always tell my people in that is don't look at— unfortunately, don't look at couples therapy as couples therapy if you find yourself in a situation that I just described. This isn't your individual therapist. You're using couples therapy as a vehicle for whatever it is. It might be trying to— this is the only place that your partner will actually talk, or this is the only place where you guys actually have the designated time to talk about the bad events that happened in the week, even if it totally becomes chaotic. It's the only time or the only place that it gets discussed. So in your mind, remember, why am I going to couples therapy? And keep that as the goal. It's not— and don't look at it like it's traditional couples therapy. Change the narrative in your mind of why you're going. All right. Well, thank you guys for coming and being so interactive. I really appreciate it, and we will see. I will see you in two weeks, and Amber will be back next week. Bye.