Disclosure of Relapse Impact for Addicts and Partners M. Deborah Corley, PhD Sante Center for Healing Jennifer Schneider, MD, PhD Tucson, AZ

Objectives Examine impact of disclosure of relapse on trust, communication, sexual relations, and relationship satisfaction for partners and addicts Discuss how partners viewed self as co- addicts or victims of relational trauma Utilize information contained in this research to better prepare couples for possible relapse and building stronger relationships

Disclosure & Relapse ● Disclosure is recommended by both addiction therapists and relationship therapists ● Disclosure for addict and partner is painful ● Partners often experience PTSD symptoms for lengthy periods of time after disclosure, this is increased when someone staggers the disclosure ● Relapse is common in addiction ● Partners threaten to leave, but usually don’t ● Partners and addicts can be both triggers for each other and support to each other’s recovery

Disclosure & Relapse ● Our original research - Addicts ● Most reported at least one relapse; (1/3 < 2 yr; 2-5 yr; 5+ yrs); ● 91% reported high risk acting out (behavior put partner at risk) ● Disclosure represented hope and end to secret life, but also painful emotions and loss ● Best therapists’ advise – Be honest, be general (no gory details) & wait until partner is less angry ● Most helpful support – 12-step meetings, therapy, spirituality, sponsor

Disclosure & Relapse 2 ● Our original research - Partners ● Disclosure clarified that they were not crazy, gave them hope for the future, helped them focus on self-care ● 33% had self doubt and hopelessness, others were angry & in pain ● Over half threatened to leave; less than ¼ left ● Most helpful advice – finally felt heard, not your fault, take care of yourself, addict should be honest with you ● Most helpful support – therapy, self-care, 12- step meetings, friends

Disclosure & Relapse 3 ● Our original research – Both ● Despite the pain, disclosure was the right thing to do ● Would recommend to other couples

New Research Questions ● Did the addict tell before marriage? ● Was outcome of original disclosure positive or negative? ● How many relapses? ● Was there separation? ● How many people stayed together? ● To what level has addict been honest? ● Has disclosure/addiction had impact on relationship satisfaction? ● Why do these couples stay together?

Participants Addicts Partners 62 self-identified sex addicts (62/189-33%) Mean age 47.5 (SD=12) 89.5% male 86% heterosexual 82% in committed relationship 68% college grad + 72% survivor of past abuse Over half had co- occurring DX, Depression 92 partners of sex addicts (92/126/73%) Mean age 44.4 (SD=12) 95.6% female 95.6% heterosexual 82% in committed relationship 67% college grad + 58% survivor of other abuse

Initial Disclosure Addicts Partners Pre-marriage o 34.4% said nothing o 21.3% disclosed little After initial disclosure o 77% said partner asked for more information (44% all) 25% reported all 40% reported small amount or nothing 48% impact negative 27% mixed (+/-) o 29% moved out/other room 25% impact positive Pre-marriage o 44.4% addict said nothing o 24.4% disclosed little After initial disclosure o 90% asked addict for more information (71% all) 24% reported all 40% reported small amount or nothing 28% impact negative 54% mixed (+/-) o 57% moved out/other room 19% impact positive

Relapse Addicts Partners Internet big impact o 66% porn/other OSB o 28% arranged for 1:1 Relapse common o 24% reported one o 33% reported 2-5 o 7% reported 6-10 o 32% reported > 10 65% suspected relapse Partners significantly more likely to discover the relapse than to be told (r =.29, p =.009) 36% of partner said their definition of relapse differed from addict Internet big impact o 73.8% porn/other OSB o 26.2% arranged for 1:1 Relapse common o 27% reported one o 25% reported 2-5 o 13% reported 6-10 o 34% reported > 10 63% partner suspected 69% addicts never or rarely disclosed before discovery of the relapse; high relapse = less disclose 53% of addicts said their definition of relapse differed from partner

Impact on Partner Addicts Partners Saw partner co-add/dep o 40% yes o 36.8% no o 22.8% somewhat Survivor of relational trauma o 66% yes o 19.4% no o 9.7% somewhat Co-addict/co-dependent o 41.3% yes o 40.2% no o 18.5% somewhat Survivor of relational trauma o 76.9% yes o 7.7% no o 15.4% somewhat

Impact Relationship Satisfaction Addicts Partners 68% in same relationship o 46% for 15 + years Overall relationship o 60% excellent or good o 23% okay o 17% poor/very poor Addicts rate relationship as better than partners (Ind. Smp t-test) t =3.75, p <.001 Sexual relationship o 43% got worse o 26% stayed same o 26% improved No significant difference between addict and partner 79% in same relationship o 48% for 15 + years Overall relationship o 33% excellent or good o 28% okay o 39% poor/very poor Sexual relationship o 54% got worse (23% no sex) o 26% stayed same o 20% improved

Impact Relationship Satisfaction Addicts Partners 26% damage = never trust again 56% talked more about emotional issues 57% felt partner helped recovery (t = 3.42, p =.001) 38.5 damage = never trust again (t = 2.47, p =.015) 57% talked more about emotional issues 24% felt addict helped recovery

Relationship Satisfaction Matters ● For partners higher relationship satisfaction was positively correlated to ● Sexual Satisfaction (r =.49, p <.001) ● Discussing emotional issues (r =.37, p <.005) ● Level of trust (r =.55, p <.001) ● For addicts higher relationship satisfaction was positively correlated to: ● Sexual Satisfaction (r =.66, p <.001) ● Discussing emotional issues (r =.57, p <.001) ● Level of trust (r =.50, p <.001) ● Viewing partner as helpful to recovery (r =.35, p <.008)

# of Relapses & Discovery Matters ● For Partners, differences in what constitutes a relapse ● Relationship satisfaction (r = -.42, p =.001) ● Sexual satisfaction (r = -.35, p =.001) ● Discussion of emotional issues (r = -.20, p =.059) ● Level of trust (r = -.25, p =.016) ● For partners -- the greater number of relapse, the lower levels of satisfaction ● Relationship satisfaction (r = -.22, p =.05) ● Sexual Satisfaction (r = -20, p =.08) ● Discussing emotional issues (r = -.26, p =.020) ● Level of trust (no significant relationship with # of relapses) ● Partner discovered before addict disclosure ● Relationship satisfaction (r = -.27, p =.011) ● Sexual satisfaction (no significant difference) ● Discussion of emotional issues (r = -.20, p =.067) ● Level of trust (r = -.23, p =.033)

Partner Reasons to Stay VS Leave ● Reasons Got Back Together Mate got help – 49% Commitment/love – 27% Children or finances – 10% Other – 14% ● Stay Despite Relapse Value of relationship to partner – 26% Children or finances – 23% Mate committed to recovery – 23% Faith/hope – 7% Other – 20% ● Reasons to Leave (some gave more than one answer) Relapse – 48% / Dishonesty – 29% / Stops Recovery Work – 26% Fear of Abuse – 6% Other – 19%

Addict Reasons to Leave ● Reasons Partner Agreed to Stay Mate continues to get help/ go to program/stay sober – 80% None/Don’t know – 14% Partner left – 6% ● Reasons to Leave (some gave more than one answer) Partner cheats on me – 11% Loss of hope, giving up – 11% Partner returns to unhealthy relationship behavior (abusive, shames me, belittles me, codependent, no forgiveness – 34% Nothing Could Make Me Leave – 34% Other – 10%

Conclusions - Lies Don’t Help ● From the beginning most addicts lie (even to us) and it hurts everyone ● Fear or trait or both ● Partners often lie to themselves, others as well ● Fear, denial, trait, or all ● Addicts nor partners are very good at utilizing each other to support or improve own recovery program; for those that do, it helps ● One third of addicts told partner nothing of their struggles with their addiction ● Almost one third of addicts did not know if their definition of relapse was same as partners ● Only a quarter of addicts had plan of what to do if relapsed, but only one third of those followed that plan

Conclusions - 2 ● Disclosure trumps discovery ● Agree on what partner wants to know, process will follow ● Relapse happens, plan for it, follow the plan, re- evaluate, improve ● Agree on definitions/levels of relapse/consequences ● Framing polygraph as tool for sobriety, not failure of probation ● Time in program; seeing positive progress helps ● Importance of couple commitment

Recommendations ● Addicts need to work on 100% honesty ● Addicts and partners need a plan for dealing with lies and relapses ● Disclosure process that honors honesty but also has process for dealing with shame, anger, and fear. ● Couples will benefit from couple goal setting and working to making relationship stronger; cherish don’t trash ● Celebrate recovery and commitment

Future research ● Pair addicts and partners in the data set if can (more risk of emotional harm) ● Role of shame for both addicts and partners ● Responses of those who have had couples therapy compared to those with addiction therapy or nothing but meetings ● Utilize some attachment and satisfaction with relationship instruments to compare.

Q & A

Thanks ● Joshua Hook, PhD & Sara Pollard, MA from UNT for data analysis ● David Delmonico, PhD for help securing IRB from Duquesne University ● Bill Herring and his group for input for addict survey and thoughts about the results ● All of you who helped get addicts and partners to the survey.