Relationships with Someone in Active Substance Use Disorder

A significant part of my practice is working with people who are in a relationship with someone in active substance use disorder (SUD). At the start of our work, the client often sees very few ways in which they enable the addictive behavior to thrive. If you are in this kind of relationship, consider the following:

·       Do you use a substance with this person, even occasionally? Have you considered how this can send a mixed message: “Your substance abuse is a problem, but let’s use together now.”

·       Do you fall for deflection, a classic defense in SUD? When you say, “Your using is destroying our relationship,” and the person replies with, “Yeh, well, you spend too much,” or, “You drank at the party the other night, too,” and you switch to defending yourself, the SUD has now been effective in manipulating the conversation away from the issue you started with.

·       Do you allow other issues to be accepted as being on equal footing with a SUD? Does the person argue, “If you would just have sex more often with me, I wouldn’t use,” and you see that issue as being on the same level as a SUD? If so, this misses a fundamental fact about SUD – that a SUD creates a “competing attachment,” meaning the substance has become that person’s primary relationship and you are now the interloper who can stay as long as you accept this position. This is a more severe level of relationship issue from things like the division of labor in the home, money, where you live, etc.

·       Do you compensate for the person to make it easier for them to abuse a substance? For example, is it understood that you are always the designated driver when going out without even a discussion about how you feel about it?

·       Do you allow shame to keep the fact that a SUD has infiltrated your family a secret, so it thrives, in part, by isolating you and operating in the dark?

·       Do you complain to others about the person’s addictive behavior but avoid getting help for yourself, and therefore avoid taking responsibility for your own codependence?

If a significant portion of these resonate with you, help is available. Therapy for codependence can be life-changing and freeing, but let’s also acknowledge something change is scary. For many people, pain that is familiar and comfortable is less scary than the unknown of change. What will life be like if I set and hold a firm boundary about my self-worth? What if this means that I may have to face being healthy alone for a time rather than sick with someone else, and being alone is scary? Who will I be if I don’t get my value from feeling responsible for other people’s feelings? These questions are part of the ambivalence around change that can be explored in therapy at a pace the client’s nervous system can handle.

SUDs love when we don’t address them directly. They thrive in the dark and their favorite friend is shame. It’s as if the SUD tells shame, “You go in first and I’ll be right behind you.” One of the best things to do to counter this is to talk to someone who knows SUD and knows how to un-do aloneness so the family has a chance for lasting, positive change. In addition to therapy, I offer a wealth of resources to support codependence recovery. Call today to learn more.

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