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A substance abuse problem can easily tear apart a relationship, but what happens when the people in the relationship are both using drugs? What happens when drug use, by one partner or both, threatens the wellbeing of the couple’s children? Drug rehab centers for couples offer specific, tailored treatment to address the corrupted dynamics that exist between partners in these situations and to give them the tools they need to repair their relationship.
Tragically, relationships where both members use drugs are quite common. The Psychiatric Clinics of North America journal notes that women who use drugs or alcohol are twice as likely as men to have a partner who also abuses substances.
According to the American Association for Marriage and Family Therapy, signs of substance abuse affecting the functioning of a relationship include:
It is very likely that these problems occur in combination, pushing the relationship to the brink of termination and endangering the wellbeing of one partner or the couple’s children. As with any form of substance abuse, professional help should be sought at the first sign of trouble, and individuals should not wait until the situation has escalated to the point where the drug or alcohol abuse can cause lasting and permanent damage.
Some treatment centers are equipped to offer therapy to both members in the relationship, but whether the two partners will go through rehabilitation together depends on the medical evaluation and opinion of their doctor. In a study entitled “I love you … and heroin: care and collusion among drug-using couples,” the Substance Abuse Treatment, Prevention and Policy journal notes that a strong relationship between the partners can be helpful as they go through rehab together, and the strength of the union can provide a sense of motivation and incentive to get and stay sober. To capitalize on this, a number of treatment facilities offer couples the option of attending the same rehab program if the admitting doctor feels that the two partners are equally committed to recovery and that they can feed off their connection to one another. The desire to get better is a huge component of a successful recovery, and investing in a romantic partner (and having that investment reciprocated) bodes extremely well for the relationship as a whole.
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However, it may be the case that attending treatment together is not possible. A doctor may make this determination if either partner in the relationship has specific issues that have to be treated separately, issues that may not be readily treated if the couple is sharing space within the facility. If there is a history or threat of violence and abuse from one partner to the other (or both partners to each other), or if one partner has psychological or medical issues that require more extensive care, then it would be in the best interests of both members of the relationship to receive treatment and counseling separately.
Nonetheless, the partners will not be completely isolated, especially if they demonstrate a commitment to making the relationship, and recovery, work. They might still get to see and communicate with each other by means of therapy sessions multiple times a week, and curated visits might also be arranged as part of the therapy. But if it is felt that recovery is better assured by keeping the partners sequestered, the two would be housed in different parts of the facility or even in different facilities.
Research published in the Journal of Substance Abuse Treatment suggests that even if only one person in the relationship is abusing drugs or alcohol, working with both partners has benefits, and better reduces the risk of relapse, than if only the substance using-partner received treatment.
The risk of relapse is taken into consideration in any form of treatment, and it is no different for couples receiving therapy for drug abuse. Even if only one partner is using drugs or alcohol and that partner completes rehab, the possibility of relapsing will always have to be taken into consideration. In a relationship, the triggers might be based on powerful emotions or physical actions (like arguing or sex, even though fighting is an important dynamic in a relationship if done properly).
Similarly, bad habits in a relationship, such as codependency (where the relationship is emotionally unbalanced and abusive) or enabling (where the substance abuse is actively or passively encouraged under the belief that it is for the good of the union), will continue unchecked unless both members of the relationship receive treatment, even if the treatment is administered separately.
As a result of this, rehabilitation for couples focuses on how to develop a new foundation for the relationship, such as placing abstinence and support at the center of the partnership. This can be expanded into new ways of interacting, and new ways of spending time together, without having to use drugs or alcohol to facilitate emotions or physical intimacy. As with any form of therapy, this will not be a quick or easy process, but the hard work of recovery (especially recovery with a loved one) adds depth to the relationship and creates new ways for the two partners to see and invest in each other.
When the couple completes rehab together, managing recovery as a team takes on an entirely new dynamic. Both members can offer support and comfort for the future challenges of sober life in the real world. Their commitment to one another, which should have been informed and enlightened by the therapy they received, will help each partner keep the other on track (regardless of whether only one partner abused substances, or both did); they will have a better understanding of each other’s triggers and their own; and they can serve as sober sponsors to one another, reminding each other about what they learned and went through in treatment together. While both should still attend peer support groups, like Alcoholics Anonymous or another 12-Step program, the benefit of couples going through rehab together is that each person in the relationship has their own sober friend as a loved one and can be a sober friend themselves.
However, as much as relapse is always a risk for a newly sober person, the danger in a recovering relationship is that if one partner relapses, the other might follow suit, or that the other partner might be subject to physical or emotional abuse and any children in the home might be affected as well. This is an important area where being connected to an aftercare program (like a 12-Step group) could save not only a partner’s sobriety, but the relationship itself. Learning from other couples who have gone through a similar experience is an invaluable step in overcoming the stumbles of recovery and adding to the new strength of the relationship.
Whether treatment is received together or apart, most rehab for couples will revolve around some basics. Some of the topics covered might include:
If the couple receiving therapy is married, then there is a strong chance that both partners will have deep (and perhaps far-reaching) family ties that have also been affected by the drug use. For that reason, drug rehab for married couples may be a bit more extensive than rehab for couples who cohabitate or couples where there are no children or in-laws. This may involve family therapy sessions where children and other members of the family are invited to participate or classes that focus on childcare, money management, and legal matters as they relate to a married couple.
An important component of any relationship is time spent apart, where both members are free to explore their own interests and hobbies, or simply enjoy solitude, without constantly ceding personal and emotional space to their partner. For a couple going through recovery together, this component takes on a new dynamic; it is expected that both members will look out for one another, providing support and encouragement when sobriety gets difficult, and sharing intimacy and love to build one another up. Doing this, while respecting boundaries and allowing the other partner to flourish on their own might seem difficult to balance at first. This is another area where counseling and therapy can help. Finding the sweet spot between spending time together and spending time apart is a tough act for any couple, let alone a partnership that has been corrupted by substance abuse, and let alone a union that is learning new ways of living and loving each other.
Drug rehab that focuses on couples, and having sober friends and other couples in recovery, will help the partners in a relationship understand how they can be there for each other and, importantly, how they can be there for themselves too. The alternative is a relationship where one partner completely defers to the other, creating a very unhealthy and unbalanced dynamic.
In drug rehab for couples, a therapist might borrow a particular technique from general couples therapy and combine it with substance abuse treatment philosophies. The hybrid is known as Integrative Behavioral Couples Therapy, which seeks to improve how the relationship works for both partners by helping each partner understand better how their loved one’s emotions work. Researchers writing in the Journal of Consulting and Clinical Psychology noted that problems as a result of drug abuse in the relationship arise from how partners react emotionally to the effects of the drug abuse and not just the abuse itself. Integrated Behavioral Couples Therapy examines the emotional context between the people in a relationship and helps them “make deliberate changes” in how they address and respond to problems.
Acceptance is at the foundation of drug therapy for couples: accepting that the drug use is a problem and accepting that the relationship needs to change. If these two truths are accepted, then eliminating drug use, reducing conflict, and improving communication within the relationship come much easier. Both partners are on the same page and the same team.