Benefits of Couples Rehab

Many rehab programs don’t accept couples, placing more emphasis on individual recovery first. However, the thinking is beginning to change. Research shows that there are benefits to simultaneously addressing the needs of each partner individually as well as the couple as a whole through couples addiction therapy. Relationship stability is one of the biggest predictors of long-term recovery, so it makes sense to help couples restructure their interaction patterns in ways that are conducive to achieving and maintaining sobriety. The key to success is for both partners to have a mutual goal of recovery. If only one member of the couple is committed to getting sober, it can undermine substance abuse treatment for couples.

Triggers for Substance Abuse in Couples

Stress is one of the biggest triggers for substance abuse and relapse after recovery. The following relationship issues commonly present in couples and can contribute to stress:

• Criticism, abusive language, and contempt coming from a place of superiority
• Problems with conflict and unhappiness
• Lack of emotional connection
• Intimacy issues related to sexual and emotional attunement 
• Psychological issues impacting the relationship such as depression, anxiety, domestic violence, emotional abuse, and trauma
• Low trust

Couples with these issues may argue frequently, which can even become violent. Fighting can create a situation where one or both partners turn to substances to reduce stress. Eventually substance use can become one of the main reasons for fighting, creating a vicious cycle in which substance use causes conflict and the conflict leads to more substance use as a way of reducing tension.  This continues to escalate until both partners are in a downward spiral and potentially struggling with addiction.  

Common Barriers to Couples Rehab

There is often reluctance to seek couples drug treatment for a variety of reasons. Some couples may be in denial that there is a problem or feel they don’t need professional help. Others may believe that couples rehab requires being medicated and hospitalized. There may also be guilt and shame, or a perceived inability to quit substance use and fear of failure. Both partners’ readiness for treatment can be another big factor. If one member of the couple desires therapy while the other wants to continue abusing drugs, that can be an obstacle to treatment. In addition, it can be difficult for couples to enter rehab together if they have childcare responsibilities or concerns about their jobs. Support for couples substance abuse counseling from family members, community members and employers can help overcome these barriers and encourage couples to get addiction treatment.

Approaches to Couples Addiction Therapy

Couples addiction therapy can start anytime after completion of detox. Initially the focus is on stopping substance use and promoting abstinence. The couple reinforces their commitment to not to drink or use drugs each day, along with taking any prescribed medications for recovery such as naltrexone or suboxone. Attending 12-step or other community meetings together is also recommended. Should one member of the couple relapse, it should be viewed as a learning experience not a failure or reason to give up hope. 

During therapy, there is a process of identifying and shedding previous beliefs and behaviors surrounding the addiction. Maybe one partner was taught at a young age not to express anger, so they kept their emotions bottled up inside and turned to alcohol or drugs for relief. One or both partners may have experienced trauma, which can affect how they deal with emotions, stress, relationships, and intimacy. It can cause insecure attachment or anxious attachment, limiting the ability to form healthy relationships. Everyone has filters based on what they learned from family about how to express feelings, be in relationships, deal with alcohol/substances, roles, rules, perfectionism, etc. It’s important to process as individuals and as a couple beliefs about expressing emotions, love, parenting, sex and sexuality, trust, and self-care vs selfishness in order to understand how this belief system might be impacting current behavior. That creates opportunities to identify aspects that no longer work for the couple and map out strategies for change. 

It’s important for couples to talk about the impact of an addictive disorder on themselves, the relationship and the family. Couples in recovery may have been traumatized by their behavior during active addiction and need support to process that. They may have hurt their partner or family members, lost their job, wrecked their car, or experienced other significant life events. In talking through it as a couple, the narrative can change from blaming and accusing to understanding that the couple has been impacted by addiction and experienced trauma together.

Interdependency (not codependency) is a good thing in a relationship when there is structure and boundaries, so that should be encouraged in a healthy way. Interdependecy involves the partners’ understanding and agreement to be able to express to one another their thoughts, feelings, ideas, and needs. The couple can work on expressing emotions without being controlling or codependent. Example: one partner decides to cut back on AA meetings from 5 per week to 1. The other partner can express their feelings and say that makes them anxious, saying “I would prefer you not do that, but it’s your choice.” It’s figuring out how emotions can be expressed without fitting into codependent, controlling behavior where the partner is trying to compensate for chaos introduced to the relationship.

It’s also important to identify and address any comorbidities that might be impacting the relationship and addiction recovery. This could include depression, anxiety, challenges with emotional expression, neurodiversity such as ADD, or other cognitive challenges that partners might be experiencing. If it’s identified early, it can be incorporated into individual and couples therapy.

Over time, the emphasis can shift to further strengthening the relationship itself as the couple learns to improve communication and listening skills, resolve conflicts, and increase positive feelings and commitment to each other. It’s important for each partner to feel understood and supported. Sometimes couples struggle in early recovery because their lives previously revolved around substance use and they feel they no longer have anything in common. That has to be normalized, moving from a relationship where the substance was the organizer to one where recovery is the organizer. Couples can share the struggles and uncertainty of recovery together, supporting each other as they heal from addiction. 

While acknowledging the shared history of addiction, they can begin to relearn intimacy and how to be in a relationship, defining a path forward together by creating new rituals of connection. The therapist can facilitate a conversation between partners and help them establish routines and rituals to stabilize the family system and promote healing. Addiction tends to create chaos and disrupt daily life, so integrating these things is necessary to bring consistency and safety to the relationship. Routines could include meal planning and prep, childcare, budgeting and spending, chores, home maintenance, etc. These are predictable things that are core to family life. Rituals might be taking walks together, setting up regular check-in meetings, shared meditation, or developing new sober ways to celebrate holidays or events. It can be anything as long as it’s predictable as well as meaningful. 

Does Couples Rehab Work?

At Discovery Point Retreat, we can help couples overcome addiction and rebuild a healthy relationship. People are more likely to maintain their sobriety if they have strong, healthy, supportive relationships, and couples addiction treatment can help achieve that. Our full continuum of care including detox, residential and outpatient couples rehab programs enable us to meet each couple where they are and support them throughout their journey to sobriety. 

If your relationship has been affected by addiction, reach out to us at 855-306-8054 for a confidential conversation about your situation and how we can help.