Counseling

Not all substance use solicits aggressive responses and some couples bring concerns into therapy pertaining to how their partners consumption of alcohol or drugs makes them distant.  People use drugs to feel what they desire, and that could be the craving for more energy, to calm down, or to have a hallucinating experience.  I tell people that if drugs did not work, no one would use them, and they create problems when the user begins to get used by the drug.  The attachment a user develops with a drug begins to mirror a domestically violent relationship.  The user starts to get beat up physically, mentally, and emotionally by the drug but still cannot find the strength to stop using.  Just like the intimate partner who keeps going back or refuses to leave the abusive relationship, drug users find themselves trapped by fear, self-doubt, or low self-worth which keeps them using the substance.

Outside of the use of legally prescribed medications that are properly managed under the care of a physician, who requires routine follow up visits, drug use should be prohibited because our minds, bodies, and lives are constantly changing.  The major disadvantage of self-medicating with illicit drugs is the absence of a trained professional present to regulate and manage the changes in dosages and side effects.  This can lead to overdoses, addiction, and withdraws which in some cases can be lethal depending on the substance of choice.  Alcohol and drugs by themselves are not a problem, the issues come when user begin to display signs and symptoms of substance use, withdraw, or intoxication defined by the Diagnostic and Statistical Manual of Mental Disorders. Known as the DSM, it  is the international manual all mental health providers use to diagnosis both substance abuse and mental health disorders.  The DSM list eleven signs and symptoms that are associated with diagnosing clients with mid, moderate, and severe substance use disorders. Clinicians look for these signs and symptoms when administering comprehensive assessments, which include rendering screenings, questionnaires, and bio-social clinical interviews.  Other factors such as family and health histories, occupation, legal issues, and personality traits also should be considered when determining if one should decide to engage in substances use or remain sober.

How Couples Therapy Helps

Alcohol consumers and drug users are known to be very defensive when approached in any manner that challenges or threatens their continued substance use.  When working with couples who self-report substance use, the first step is to establish a rapport to assist with lowering their defenses. This approach is phase one of a therapeutic method called Motivational Interviewing.  Motivational Interviewing is essentially a conversation that assists with evoking change.  In couples’ therapy, this exchange is usually directed toward one partner who has displayed multiple signs and symptoms of having a substance use disorder.  This therapeutic process is helpful in getting the substance using partner to make changes by identifying how their alcohol or drug use has negatively impacted themselves, their intimate partner, and their family.  It takes time to implement this process and the end goal is to get the identified substance using partner or the couple ready to seek substance abuse treatment.  The time length for getting clients ready to enter treatment varies.

The four intimate relationship losses caused by alcohol and drug use

1. Loss of Control: The substance using partner’s good decision-making power which allows them to regulate their alcohol and drug use is negated.

1. Loss of Trust: The substance using partner begins to lie about or underreport their alcohol or substance use to avoid arguments or request from their intimate partner they stop using.

1. Loss of Existence: The substance using partner feels a need or desire to engage in the use of alcohol or drugs all the time just to feel present or to escape life.

1. Loss of Safety: The substance using partner becomes physically or verbally aggressive, irritable, or undesirable to be around when under the influence or withdrawing from alcohol and drugs.

Written by Chris A. Matthews

Each intimate partner’s unique worldview is shaped by their past and current life experiences.  In an attempt to convince their spouse to see the world through their own individual lens, couples will engage in arguments. Arguments are healthy exchanges of thoughts and ideas that are driven by each partner’s level of passion for the topic being debated.  When both partners take turns speaking and listening, arguments become healthy persuasive conversations that couples use to settle disputes, make joint decisions, and express their point of view regarding a particular subject matter.  Arguments become problematic when partners disable their ability to hear each other.  When this happens, couples transition from arguing to fighting.  A fight is intended to produce a loser and a winner. The main goal of an argument is to identify a mutual intersection where both partners thoughts, feelings, and ideas can cross over.  Once each partner has respectfully expressed themselves, the couple can move forward with creating one harmonious perspective the relationship can adopt.  When a partner approaches an argument with the intention of winning or beating their spouse, then they are engaging in a fight.  Arguments are designed to produce resolutions that pull intimate partners together through speaking and listening to one another’s worldviews.  Tone is the main factor to be aware of that causes couples to stop hearing each other during arguments.  Every part of the argument or persuasive conversation is important, but the startup holds the most value because it sets the tone for how the discussion will play out. Tone is impacted by the attitude each partner brings into the conversation and influences the volume used to transmit verbal messages. Healthy arguments start when partners communicate in a tone that pulls their spouse in and creates a desire to engage.  Partners who are calm and reflect tones that invite their spouse in make it easier to start the argument in a non-combative fashion.  The opposite would be true for partners that have an aggressive and demanding approach that makes their spouse become defensive at the start of the argument.  Good tone  has to be coupled with good timing that activates arguments that conclude with each spouse feeling heard.  Finding the right time to engage in an argument is important because partners may need to prepare themselves to listen.

How Therapy Helps

Couples will seek therapy because they do not know how to argue without transitioning the dialogue into a fight. Fights are more likely to develop when the couple loses sight of purpose or forget why they began the argument to start with. At this point they are then driven by heightened emotions and start to hurt each other.  These exchanges quickly develop when either partner feels attacked during the conversation. When partners feel attacked, they will automatically start to defend themselves.  Defensiveness looks like shooting back insults, placing blame, or shutting down and refusing to engage.   These behavior responses are taught through observations and past experiences.  In therapy couples process how they were introduced to fighting and what steps they need to apply in order to rewire any of their faulty training. Several intimate partners are taught at an early age that if someone hits them, they should hit them back.  The problem with this methodology is that when we form intimate relationships this eye for an eye approach produces two people that can no longer see.  Couples become blinded by anger, pain, and rage.  These negative emotions drive couples to hurting each other which goes against the premise of establishing a healthy intimate relationship.  Therapist can help couples identify when they start to feel attacked during an argument and how to express their feelings, so their partner is aware.  This is done through a verity of techniques that allow couples to revisit their arrangements in the control setting of a therapy room.  This approach is similar to how an athlete watches game footage to see what mistakes they made so they can correct the actions during the next game.  Therapy helps partners with processing their arguments so they can practice having persuasive conversations that sustain respect and conclude with resolutions.  Partners have to learn each other’s triggers and make a choice to not purposefully hurt each other when they argue their thoughts, feelings, or emotions.

The Four T’s of Arguments Between Intimate Partners

1. Timing- The moment when partners become triggered by an activating event, thought, or emotion that leads to the start of an argument despite the setting or environment.
2. Tone- The attitudes and communication styles projected and received by partners who engage in planed and unplanned arguments, emotionally charged dialogs, or conversations.
3. Topic- The subject, event, need, want, or noun that provoked some emotion, thought, or belief within one or both partners the argument originated from or stems around.
4. Triumph- The conclusion of the argument which can be a solution, resolution, compromise, or a result that leads both partners toward adopting a joint perspective on how they will move forward together in the relationship.

Written by Chris A. Matthews, LMFT

Infidelity is defined as any action that threatens or breaches the intimate relationship contract in regard to how both partners choose to conduct themselves around other people outside of the intimate relationship.  The problem I witness from the lens of a therapist, is that the majority of couples entering counseling have failed to write down or make clear what their relationship guidelines are.  I share with couples that when they purchase a car or home, they take the time to commit to paperwork outlining the standards of a loan. Establishing an intimate relationship should be no different than entering any other formal contractual agreement. Developing an agreement of standards that outlines what both partners need to feel, safeguards both parties from misunderstandings. Intimate partners can protect themselves from the onset of the relationship by properly communicating and documenting what they expect. Each partner is responsible for communicating their own unique perspectives around what they believe constitutes as infidelity.  Moreover, each partner needs to have the freedom to update or make changes to the agreement based on future relationship experiences.  For example, if two heterosexual intimate partners consent to having opposite sex friendships at the initiation of the relationship, this standard may change if one partner is caught engaging in an act that threatens the binding relationship agreement.  This could look like one of the partners choosing to send inappropriate text messages or social media corresponds to an opposite sex friend.  When the other intimate partner reads the exchange, they may ask that the relationship agreement exclude the ability to sustain opposite sex friendships until their trust is restored. They may even go as far as viewing the act as grounds for terminating the entire intimate relationship all together.  Choosing to be with a specific intimate partner is always a choice and people need to choose wisely.  Once that choice is made, the next step is to design an agreement that lists a set of standards that protects each other’s investment of time.  When I share this in sessions with some couples they question if developing a relationship contract will distort their natural flow.  My reply, accountability does not eradicate spontaneity or creativity.  Instead, security increases the possibility of more spontaneity because it provides a  playing field for both partners to feel safe. In order for intimate partners to feel safe and prevent the onset of infidelity, they have to establish agreed upon rules that define how they expect each other to conduct themselves with others outside of the intimate relationship.

Common Types of Infidelity

The two types of infidelity are emotional cheating and physical cheating. Affairs are the combination of emotional and physical cheating that occur over multiple interactions with the same person or several outside partners.  All forms of infidelity are rooted in the act of breeching intimate relationship standards of physical and emotional conduct, defined by the betrayed partner.  The betrayed partner is the individual who experiences sorrow, anger, and distress often followed by grief, after learning their partner broke the intimate relationship circle of trust.  Since every person is different, some partners find it harder to forgive certain acts of infidelity over others.  In my work with couples who bring issues pertaining to infidelity into therapy, affairs are always the hardest to treat because both partners are simultaneously experiencing grief and loss.  The offending partner, or cheater, is coping with the end of a relationship they established that was meeting needs outside of their primary intimate relationship. The betrayed partner is dealing with the loss of security which is stripped away after learning they have been sharing their partner with another person.  Although the thought might be that the cheating partner should not have any room or empathy to feel pain, since they initiated the betrayal, a good couple’s therapist understands both partners are dealing with loss. To support the work that has to be done in therapy, I suggest that each partner speak to their primary care doctor or a psychiatrist to inquire about the need of a prescription to cope with their emotions.  This is highly recommended when either partners ability to function is threaten for an extended period of time. Couples who decided to do the painstaking work of rebuilding an intimate relationship after infidelity, should start the process expecting to feel an unsurmountable level of emotional pain.  This is due to the fact that in order for couples to rebuild, they have to process what happened and why it happened.  This can look like the betrayed partner choosing to know every detail of the affair and if the cheating partner fails to be descriptive or leaves out information, trust will never begin to be reestablished.  The greatest satisfaction I receive from doing couples therapy comes from working with partners who are able to rebuild a better relationship after infidelity. These couples are some of the most resilient human beings I have ever met, and it is always an honor to be a part of their healing and rebuilding process.  At the onset of therapy, I inform couples treating infidelity they will never get the same relationship back, but they can choose to build a stronger, better relationship.  I use the metaphor of a house fire, in that the original home was burned down and no matter what they do it will not come back. Hurt partners never forget the infidelity happened but they can choose to rebuild their relationship on the same lot.  Not all is lost, because couples can cipher through  the ashes of their old relationship and find things that still work so they take them into their new union. I recall, working with a couple who before and after the infidelity they did a great job co-parenting, sharing household responsibilities, and providing financially for each other and their family.  These characteristics were not only transferred into the new marriage but served as the motivation they both needed to successfully do the hard work required to rebuild a stronger relationship after infidelity.

The Four Primary Types of Infidelity

1. Cheating: Engaging in any forms of emotional or physical contact with another person live or via the use of technology, that your intimate relationship partner may deem as inappropriate, hurtful, or disrespectful based on the agreed upon committed relationship standards you both defined.
2. Affair: Allocating resources such as money, time, and attention toward sustaining a secretive physical and emotional secondary intimate relationship designed to fill a void that is not currently being met by your primary intimate partner.
3. Exploring: Operating in any manner that appears to be an attempt to establish a secretive romantic connection with another person outside of your intimate relationship.
4. Engaging: Sustained contact with any person that your intimate partner has requested you end all communication with because your involvement with that person makes them feel unsafe.

Written by Chris A. Matthews, LMFT