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Pain may come from any of the natural consequences of their addiction, such as loss of job, physical illness, rejection of friends. I love you too much to return to you now, she told him. Dan came back the next night and begged for Barbara’s return. He would go to treatment if she would just return. Barbara recognized this as a further attempt to manipulate her. I love you too much to return to you now, she told him. If I return, it will be after you have dealt with your alcoholism and after we have dealt with our many marital problems. She told him of a treatment program in a nearby city and assured him that she would work with him on getting into the program, that, in fact, she and the children would come on occasion for counseling sessions with him at the treatment center’s request. Dan, we have a serious problem, she continued. It is not going to go away by itself. He learned about alcoholism, but he also learned more about himself. For the first time in his life, Dan began to realize that life in the real world could be much more satisfying than life in the delusional world of alcohol. 
All Fall Down
This time, Dan was not begging for Barbara to return. He also recognized that he had a great deal to learn about how to relate to his wife and his children. I began extensive marriage and family counseling with Dan and Barbara and their children, which nine months later resulted in Barbara and the children moving back home. Dan had only one brief relapse during the nine months. He was at a business meeting and thought that he could have a drink socially without getting drunk. One drink led to two and before the evening was over, Dan had to be taken home in a taxi. He also shared this information with Barbara and later with me in our counseling session. This openness was far different from his previous style of denial and lying. Barbara and Dan both had a high level of confidence that their marriage would be vastly different from the past ten years. As of this writing, it’s been five years since I last counseled with Barbara and Dan, but every Christmas I’ve received a card and a brief note recounting some of the events of the year. Always they express their gratitude. Barbara and Dan’s story is a success case. Make It Like A Memory
They have tried sensible conversation, angry lectures, silent withdrawal, crying, pleading, trying to save face, making excuses, picking up the pieces, and hoping against hope that their spouses will change. But the deepest pain that an addict can experience is the thought of losing a spouse or some other deeply significant person in his life. That is what motivated Dan to seek treatment, and that is what motivates most addicts to seek treatment. The thought of losing the one person who means the most to them in the whole world is enough pain to motivate many addicts to reach out for help. These patterns do not change easily. There are three basic formats for treating drug abusers. One is outpatient therapy. The outpatient program typically provides a time for detoxification if needed, weekly meetings, individual and group counseling, peer counseling, and frequent urine drug screening. Peer counseling and urine screening are extremely important. The addict cannot con other addicts. Confrontation by their peers is strong confrontation. Knowing that he or she is going to be tested for drugs is a strong deterrent and motivates the drug user to say no to temptation. Attention Is A Prize
Outpatient programs are less expensive and less disruptive to one’s work and family relationships. Inpatient treatment is a more intensive program. It usually involves detoxification, educational training, group and individual therapy, family involvement, and sometimes occupational and recreational therapy. Those who have been addicted for a long period of time, or are in poor health, or are in a living environment that encourages drug use usually need an inpatient program. A third approach to treating the substance abuser is a residential program. Residential programs usually run from six months to a year. Usually, such programs include educational and vocational training along with group activities. Typically, counseling focuses not only on treating drug abuse but also on dealing with any underlying emotional/relational problems. Residential programs are more commonly used with adolescents or young adults than with older adults. You can find information on available treatment centers through your Al–Anon support group, a local counselor or pastor, your local mental health clinic, or by talking with friends.7 It is always advisable to learn as much about a treatment program as possible early in the process so that when your spouse is ready for treatment, you will be ready with a viable suggestion. Most treatment programs welcome visits and are happy to discuss with family members their methods and costs of treatments. Costs vary greatly among treatment programs. Most health insurance programs have provision for addiction treatment. You should be aware of all these details long before your spouse is willing to go for treatment. Which of these will be covered, at least, partially, by your insurance? The most common mistake of an individual married to a substance abuser is to hope that the situation will simply take care of itself, that the abuser will wake up one morning and decide to stop her addictive behavior. The reality is that this almost never happens. When one is truly addicted, it is not a matter of simply deciding to get off the drug. At this point, the body has a physical addiction to the drug and will drive the addict incessantly to meet that need. Once addicted, the abuser will need outside help to break the destructive habit. The role of the spouse who would be an agent of positive change is to let the abuser experience the results of his or her own abuse. I know that we have turned the corner.