Are You Married to a Problem Drinker? Here

Chicago Compass Counseling Blog

If alcohol counseling seems mysterious, then allow me to pull back the curtain. Here is a scene reenacted countless times per year in my office, among countless couples, the first time I meet a problem drinker:

I'm sitting in my chair with a legal pad, poised for note taking. The problem drinker - my prospective client - glares at the wall. His wife is wringing her hands, detailing the insanity of his drinking.

"I tell him to count his drinks, but he doesn't," she says.

"That's not true," he says, rolling his eyes.

I nod.

"He says he's going to change, but he doesn't," she says. "He's choosing alcohol over me, and he's choosing alcohol over the kids."

"That's ridiculous," he says. "You should see the way she drinks sometimes."

I nod again. This unstructured conversation will continue for about 2 minutes. Then I re-direct things.

"I'm not a couple’s therapist, so there are some dynamics here that I can't address," I say. "But I want us to take a moment to consider a hard fact: that on some level, problem drinking makes sense. It's not about blame - it's about the function of the behavior."

He perks up, alert and interested. She looks at me, skeptical.

"As a behaviorist, my job is to map out a problem behavior. Using that map, I learn the function, or the set of rewards, that reinforce a behavior in spite of negative consequences," I say. "So we start with something like a scientific hypothesis, an 'if-then' statement: we can only make healthy changes if we start with the assumption that his problem drinking actually makes sense." Both of them are paying attention, now.

"The fact that his drinking hurts you, his wife, is essential to acknowledge, and absolutely needs to be addressed. But here in this consultation, my aim is to focus on the problem drinking itself. So let me start by saying that the pain you are experiencing as his wife is extremely, extremely important. I want that pain to be addressed as I move forward in one-on-one counseling with your husband. You might want to seek out couples counseling, your own counseling, or some form of trusted social support."

"Ok," she says. "I can do that."

"I also want to acknowledge that it is unfair that I am asking you to do work," I say. "As his wife, you understandably feel victimized by this situation. And here I am, asking you to do work of your own."

"That's alright," she says. "Anything to make things better."

"There's another element here," I say. "There's something that needs to shift in your relationship dynamic for me to do my job. And that has to do with this idea of being The Enforcer." They look at each other, perplexed. Then they look at me.

"It happens to all couples who experience problem drinking. One of you becomes The Enforcer. Over time, you feel that it's your job to monitor his drinking, first, and to be his wife, second. And you hate that."

"I do hate it," she whispers, tearing up.

"And he hates it, too," I add.

"It's terrible," he says, shaking his head.

"So I'm here to tell you that as long as we're working together, and after we successfully complete our work, you won't ever need to be the Enforcer, again," I say to his wife. "That's my job, and his job. Every week, my task is to have him hold himself accountable, and to become his own Enforcer, over time. Because that's real life. His drinking has always been his responsibility." He nods. I make deep eye contact with his wife. "The pressure you've felt to be an Enforcer is based on an illusion. You don't like it, and he doesn't like it, and it allows him to not take responsibility."

"It's true," she says. "We are shifting things back to the way they actually are," I say. "So you can focus on being a wife rather than an Enforcer and you can focus on being a husband, rather than a criminal. Does that sound alright to both of you?"

"Yes," he says.

"Yes, absolutely," she says. "I have one question, though. Am I just supposed to ignore his drinking? Like, I can't talk about it?"

"Great question," I say. "And that leads me directly into the set of guidelines, or commitments, I ask significant others to follow, knowing that I am asking him to follow commitments related to his behavior."

The commitments for the significant other are as follows:

Significant others truly get a bad deal when problem drinking goes untreated. They are left feeling resentful and abandoned. They are left feeling responsible for a problem drinker who shirks their own responsibilities. Friends and family members who are aware of the problem may judge them for staying in the marriage, adding pressure to an already strained relationship. Is it any surprise that when problem drinking continues, unchecked, the significant other ends up becoming emotionally isolated, hypervigilent, and fearful - much like someone who suffers from PTSD?

This is precisely why I ask significant others to enlist their own professional support. No human can manage this much pressure alone.

The treatment of problem drinking must include many layers and levels of intervention. My job is to show the problem drinker where his responsibility lies, and to encourage him to honor his commitments through values-based behavior. Behavioral science clearly shows us that there is a function to bad behavior, and my task is to unearth that. It takes time - much longer than one or two sessions - and requires even more work for the significant other.

If caught in time, however, change can happen before trust, respect, and acceptance are irrevocably lost. Science and research shows us that change is possible - it just requires that first step of asking for help.
Sarah Suzuki, AM, LCSW, CADC
Hi, I'm Sarah, and I'm a counselor who helps high-achieving men learn how to moderate their drinking. I currently offer counseling services and corporate training here at Chicago Compass Counseling. If you're interested, you can read more about me on my about page.
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