When You and Your Spouse Struggle With Substance Use Disorder
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Updated: July 5, 2022

When You and Your Spouse Struggle With Substance Use Disorder

It happened again. You have told each other time and time again that this time will be the last time, but it wasn’t. You both are waking up hungover again and feeling defeated.

Struggling with substance use disorder (SUD) when you and your partner battle addiction can make days feel like a never-ending cycle of chaos. It can seem daunting to find the courage and determination to get help, but support is available; recovery is possible for you and your spouse.

Treatment for Couple With Substance Use Disorder

Over the past years, SUD has been approached as an individual problem. However, in the last 30 years, professionals have discovered the critical roles family members play in addiction treatment.

In the early 1970s, the National Institute on Alcohol Abuse and Alcoholism portrayed couples and family therapy as “One of the most outstanding current advances in psychotherapy of alcoholism,” calling for controlled studies to determine the efficacy of family-based interventions.

Behavioral couples therapy (BCT) is a family-based treatment method designed for married or cohabiting individuals battling addiction. BCT focuses on the individual seeking treatment and their partner, making it the ideal approach to fighting SUD when both parties struggle with addiction.

There are three primary goals within BCT when treating couples with SUD, including:

  1. Eliminating problematic drinking and drug use
  2. Engaging the family’s support for the client’s efforts to change
  3. Restructuring couple and family interaction patterns in ways conducive to long-term abstinence

BCT helps create a constructive cycle between substance abuse recovery and improved relationships. Interventions are used that enhance both beginning with substance-focused interventions that continue during BCT to encourage abstinence. When abstinence and attendance at BCT sessions have stabilized, the counselor adds relationship-focused interventions to improve positive activities and teach communication skills.

Procedures of Behavioral Couples Therapy

BCT derives from the three previously listed goals and helps create a constructive cycle between addiction recovery and enhanced relationships through interventions that improve both issues, beginning with substance-focused interventions that continue during BCT to encourage abstinence. When abstinence and attendance at BCT sessions have stabilized, the counselor adds relationship-focused interventions to improve positive activities and teach communication skills.

Substance-Focused Interventions: The Recovery Contract

A recovery contract involves both clients in a daily ritual to reward abstinence. The clients state their intention to avoid consuming drugs or alcohol. Each spouse expresses support for the other.

The components of a recovery contract include:

Relationship-Focused Interventions in Behavioral Couples Therapy

Two primary objectives during relationship-focused interventions include increasing positive activities and teaching communication skills to resolve conflicts more constructively.

The components of the goals throughout the intervention include:

  • Noticing when your partner is doing something nice
  • Sharing rewarding activities
  • Caring daily assignment
  • Listening skills
  • Directly expressing feelings
  • Communication sessions
  • Negotiating requests

Behavioral couples therapy permits couples to experience therapy as one, working on their problems together while still receiving the full range of treatment necessary for long-term recovery and a successful relationship.

Incorporate Recovery Into Your Relationship

Sustaining sobriety as a couple is different from maintaining abstinence independently, and it is essential to find a balance between recovery and relationship.

Having a healthy relationship with your partner helps maintain a healthy recovery. Research also indicates that friendship with your spouse is essential to maintaining an intimate relationship. How can you rebuild a relationship with your spouse that will support you throughout recovery?

The Gottman Method provides a fundamental process for counteracting destructive communication and dissolution that could affect a couple's addiction recovery. After more than 30 years of research involving 3,000 couples, Gottman developed a protocol to build communication skills, provided below:

  • Build love maps: involves couples getting to know one another's inner psychological worlds
  • Share fondness and admiration: couples learn to openly express appreciation and respect for one another to strengthen their bond
  • Turn towards each other, not away: learn to notice when your partner seeks attention, affection, and comfort and respond accordingly
  • A positive perspective: helps couples learn to see one another positively, allowing them to see mistakes as matters of circumstance instead of failures
  • Manage conflict: couples learn coping skills to handle conflict; the couple acknowledges one another’s feelings and learns to discuss their problems; when one person feels overwhelmed during an argument, they can use the techniques known to self-soothe and remain calm.
  • Make life dreams come true: centers on supporting each other in their dreams and goals
  • Creating shared meaning: involves understanding the couple's perspective and requires uncovering the routines that have shared meaning for each client

Gottman accentuates how improving friendship through building a love map, an admiration structure, and establishing an emotional connection through turning towards each other can constructively recuperate a couple’s communication.

In addition to The Gottman Method, mutual-aid groups such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or Relationship Couples Anonymous (RCA) offer a sober, supportive social network while building stress-coping skills through a 12-Step program for couples.

So many of the Twelve Steps require sacrificial love that involves making amends to those you have hurt and sharing the inspiring message of hope with others in their addiction. You have the perfect opportunity to work through several of these steps in your relationship.

Success in recovery as a couple is a unique challenge, but it is possible with support. Today, commit to one another and promise to focus on healing as a couple.

Substance addiction treatment is a chance for you and your spouse to learn and grow. The importance of investing in your relationship spreads to every facet of your life. If you and your partner struggle with alcohol or drug addiction, we want to help. Present Moments Recovery center in San Diego, California, offers a customized approach to addiction treatment with many levels of care to ensure a successful recovery for you or your partner. You can work with counselors one-on-one to ensure all needs are fulfilled. Present Moments Recovery has over seven years of experience helping individuals achieve recovery in sober housing and transitional living. Our trained staff specializes in supporting your recovery and helping you establish a firm foundation in recovery. At Present Moments Recovery, we believe healing only happens in the present moment. Call us today and learn more about our services at (619) 363-4767.


If you or a loved one is looking for an effective drug rehab in San Diego, call 619-363-4767. One of our caring members is ready to answer all of your questions.

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