1. Disclosure of Relapse Impact for Addicts and Partners M. Deborah Corley, PhD Sante Center for Healing www.santecenter.com 800-258-4250 Jennifer Schneider, MD, PhD Tucson, AZ www.jenniferschneider.com 520-990-7886

2. 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

3. 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

4. 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

5. 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

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

7. 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?

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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)

15. # 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)

16. 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%

17. 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%

18. 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

19. 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

20. 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

21. 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.

22. Q & A

23. 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.