Alaska71 is watching her husband spiral back into drinking after a spell in an intensive outpatient treatment. Angry and threatening behaviors abound, and she is also concerned about their teenaged sons, one of whom is expressing anger and blaming his father. Where to begin?
"I need help and feel at a loss. Earlier this summer my husband entered intensive outpatient rehab for alcohol misuse. His drinking had been getting progressively worse over the past 2-3 years and culminated in a very drunken night where he was belligerent and verbally abusive to me and our 15 year old son. A couple of weeks later he entered outpatient treatment. He attended for about a month when there was a Covid exposure and everything moved online. He has attended the program sporadically since then. He has been attending different online support groups with Smart Recovery and a different organization that I can't remember the name of. But since he stopped going to his outpatient treatment regularly, he has told me that he has started drinking again. He feels that he is not an alcoholic and that he can handle one beer a night. I disagree with him but tried not to freak out. He also is saying that the family has provided him with no support and that we are blaming him for everything. I have repeatedly told him that everything is not his fault and have tried to own my side of things. I am in my own therapy and we also attend couples therapy together. I also am almost done with all the modules on this site. However, he says that he is all alone and that we are doing nothing to support him. To add to the mix, my older son is 15 and very angry at his father. Recently, he has had some angry outbursts and broken a window. After he broke the window, he broke down and told me that he thinks that everything is his fault and he is totally to blame for all the problems in our family. Of course, I told him that this was not true but he is still blaming himself. The tension between my son and husband is terrible. I don't know what to do. My son started therapy today. I am worried about my family and I am worried about my son. He has said and done some terrible things but he is also only 15. My husband is very angry with him and doesn't/can't connect my son's behavior with some of the painful moments caused by my husband's drinking. Any advice would be helpful.
2nd message: My husband is in treatment for substance abuse disorder (alcohol). I have two sons aged 13 and 15. Do you know of resources either for them or for me to help them navigate this situation? I know about Alateen but am wondering about something in the CRAFT model. Thanks!"
The early warning signs of violence and physical danger: you are in it now
It was hard to breathe as I read through your comment. You are close to being in physical danger. If you thought differently and skipped Module 2, please take 20 minutes after reading this, if you can, and look through the video segments and Key Observations exercises for Module 2. (It’s faster to download the ebook and read it on the screen).
The COVID-19 pandemic has produced a massive lack of structured treatment—many in early recovery have lost their footing
The loss of solid, structured in-person treatment has caught so many Loved Ones in the midst of early recovery. We have lost many to relapse, some are homeless, and many families are shouldering this additional burden.
There’s a saying in AA: in the moments leading up to a decision to try abstinence, when you’re fooling around with the last drops of alcohol and the creeping realization that what you are learning may be right:
“you have a head full of AA and a belly full of booze.”
It sounds like your husband is in that place. You describe much upset, and most likely a high level of internal distress. Right now he is trying to keep one foot in treatment and one foot in the drinking. This cannot be a comfortable existence!
Here's how to embrace Acceptance while letting him do some experimenting and maybe reduce some of the tension for now: Can you let him try moderating?
How about accepting that this is where your husband is? How about you even consider agreeing to one drink a night (here's a recent post in which we explain how to continue CRAFT during this experiment; here is a page where you'll find all posts involving "moderating")? Would he agree to trying the Sinclair method? I would put this at the top of your "MORE treatment" list that you should be building.
The Sinclair Method is an empirically shown method whereby the Loved One takes Naltrexone (a drug that blocks the euphoria of alcohol), before a drinking episode. Here’s how it would look:
1. Your husband takes naltrexone prior to drinking, let’s say every day at noon, if he plans to drink each day.
2. He gets to drink his drink after 5 (time to be determined by the two of you).
3. You react as though he is not drinking (Module 5): you are downright chirpy (or whatever you can dredge up at this point), generally rewarding. You step in, your communication is calm and open, the topics are light ones.
Your husband will occasionally fail to keep to the one-drink maximum. You expect this. When he goes to that second drink, you remove yourself and anything rewarding (Module 6).
The Sinclair method, coupled with moderation, may succeed but if it doesn’t, the responsibility and actions to be taken by your husband should be well-defined. The ball will be in his court. You will have been just sitting on the bleachers, not addressing this adventure that unfolds before you. So, generally avoid talking about the drinking, the Naltrexone, or any other tough topic in which alcoholism has its tentacles. Here is a TED talk that gives a good idea of the Sinclair Method.
Could you consider his complaints as change talk, and seize the opportunity to offer your support?
You've reported that your husband has expressed feeling all alone and that the family is doing nothing to support him. To me, it feels like this could certainly be put in the basket of "change talk," ie, a window of opportunity to discuss next steps. It'll be an offer, and he will take it or leave it. Your list will be ready to share with him, and the next step will be his to take. If you feel up to it, you could also consider responding to such allegations with some reflective listening:
"OK. I hear you. You feel we're not doing enough to support your recovery…"
…and then add on an offer of help that requires him to get specific as to how he'd like to be better supported:
"Can you give me some concrete ideas so that I can better support you in your recovery? I love you so much and it would mean so much to me if you knew how much I want to play on your team and do anything I can to help you move forward…"
CRAFT for adolescent family members: We're looking for some good resources
We have put out a query amongst our collaborators about CRAFT for adolescents and we'll keep you abreast of what we learn. I am glad you have a lot of helpers already with your situation. If we're not able to locate CRAFT-specific help for your children, let’s hope the therapist your son just started to see sticks. I also wonder whether your couples therapist or your individual counselor would do the occasional family session. I gather you have another child whose age may lend itself to this.
Your position is not an easy one. You're in therapy, looking at your own part in all of this, while trying to practice CRAFT with your husband. Each of these alone can make for an emotional adventure. But in addition, you are managing family dynamics, which are heating up. Your sons are of an age where not much escapes them. They've got their own beef with their dad, but they're also most likely keyed into, and affected by, the tension and arguments between their parents. Everyone's upset about something. And your husband feels blame is being directed at him.
On the one hand, you can't be the one to untangle everything singlehandedly, take care of everyone's needs and carry your husband's recovery, while of course actively taking time and directing energy to taking care of your Self!! And on the other hand, it's undeniable that you are currently in a position to set the example.
The more you're able to apply CRAFT principles to your relationship with your husband (with or without an attempt at moderating), the more tensions are likely to drop considerably. You will avoid those sticky topics (how much he's using; treatment or not; ways he is disappointing the family…) and only go there in a super neutral way, if a window of opportunity (change talk) arises.. If he tries going there, you simply won't engage with him.
While we certainly would not suggest training your kids in the CRAFT method or putting any sort of expectation or responsibility on their shoulders for effecting change in the family or turning their dad's addiction around, we do believe that letting them in on your strategy can be helpful (as their age and maturity permit).
Here is the response from Dr. David Scherer, who works with us and was instrumental in the early studies of CRAFT at the University of New Mexico:
"I believe it is reasonable to include adolescents (and perhaps most children) in aspects of CRAFT, if only so they know what the game plan is. I suspect we would all agree that we don't want to put responsibility on minors to effect change in family relationships or put minors in the situation where they feel responsible for changing the "loved one's" behavior (any more than they already do); that would be a role reversal. But it would be useful for minors to know and understand that other family members are going to try to change their patterns of interaction with the "loved one" and to try to inject hope into the situation."
This might mean a short discussion with them about CRAFT/Allies in Recovery and the most basic principles that you're working on applying. This might even mean watching the intro module with one or both of them. Or whatever you are comfortable with and feel they can grasp. Their increased awareness may well lead to a bit more solidarity with you and a bit more compassion for their dad.
Your safety is paramount: Get prepared, have your emergency numbers and safe places written down or memorized
Finally, you need emergency numbers at the ready. The anger between your son and husband might exacerbate, towards each other or towards you or other children. Would you be willing to call the police? If not, who would you call? Where would you go to seek safety? You may not fear a higher level of violence, but we implore you to watch the module and do the exercises in Module 2. Violent episodes can come on seemingly unexpectedly. You'll need to be prepared.
Great to have you here from Alaska. I hope our site brings you answers and comfort going forward. Best wishes.