Disclosure of Relapse Impact for Addicts and Partners

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

10. Relapse • Internet big impact • 73.8% porn/other OSB • 26.2% arranged for 1:1 • Relapse common • 27% reported one • 25% reported 2-5 • 13% reported 6-10 • 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 Addicts Partners Internet big impact 66% porn/other OSB 28% arranged for 1:1 Relapse common 24% reported one 33% reported 2-5 7% reported 6-10 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

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

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