Substance Abuse and the Intimate Partner Relationship: Who Really Needs Help?


Substance Abuse and the Intimate Partner Relationship

As a therapist and addiction counselor, I get a lot of calls from people looking for help in relation to substance abuse. Often times the calls I receive are from the partner of someone who is addicted. They are looking to schedule counseling sessions to address their partners drinking or drug problem while they bear witness to the process. They want to be present to “explain the problem” as they don’t believe their partner can do so themselves. I would be willing to be that there is such a lack of trust in the relationship that they feel like they need to be present to ensure the “right” issues are being addressed and the whole truth is being discussed.

Get some help

My immediate thought as a therapist is “I wish this person would get some help” and by this person I mean the sober partner. Don’t get me wrong; the addicted partner needs help, however, I find that the sober partners are less likely to consider their need for counseling.

Some of you reading this may be that sober partner. You may disagree with me thinking, “I’m not the one with the drinking or drug problem, why should I go to therapy?”

It is true that you may not be struggling with drugs or alcohol in the sense that you need to drink/use to function. However, you do have a strained relationship with substances in a different way. You may not be the cause of the chaos but you are still living in it. It is easy being in a relationship with an addicted partner to lose yourself and your needs. You have become the caregiver, the worrier and the enabler all at once. When addiction is present in an intimate partner relationship there is a lot to be addressed.

Addiction impacts the whole family system

I have been working with substance abuse for years in rehabs, clinics and private practice. I have a pretty clear understanding as to why one would be motivated to get their partner into treatment. Addiction is a disease/condition that impacts the entire family system. It is why even in the self-help world there is help for family members in the form of Al Anon, an anonymous support group for family members of those impacted by addiction.

As a clinician, I have to say I am always concerned when someone calls me to make an appointment for his or her significant other. The first question I have is

“Why isn’t your partner calling?” followed by “Are they aware you are trying to make an appointment on their behalf?”

I have a personal policy where I won’t take on any patients or schedule appointments unless I speak with the would be patient directly. In order for treatment to work your partner needs to be a willing participant. Bringing someone to an intake appointment, as a surprise intervention, is not recommended.

Let’s face it; if your partner is addicted you may feel as if you are riding an emotional rollercoaster feeling anything from hopeless, depended upon, abandoned, sad and angry. When relationships involve a lack of trust, they can feel out of control. This out of control feeling can result in behaviors (conscious or unconscious) aimed at feeling in control again. These behaviors may appear to alleviate anxiety but in reality it helps keep the cycle of chaos going.

Healing may start with someone in the relationship going to rehab but that is certainly not where it ends. The family system needs to heal and you both are part of that family system. Part of that solution may be to make your own intake appointment and get your own therapist.


Jennifer Varley is a licensed Mental Health Counselor (LMHC) and a Credentialed Alcohol and Substance Abuse Counselor (CASAC) practicing in Astoria (Queens), NY. She is specialty trained in both Harm Reduction Psychotherapy and attachment focused EMDR (Eye Movement Desensitization and Reprocessing) for processing trauma. Jennifer specializes in the treatment of co-occurring disorders, mood disorders, trauma, anxiety, depression and codependency among adults.