When the Addict has a Tantrum in Your Office

It isn't so unusual, if you are a couples therapist, to see an addict act like an addict. 

When called on it he will say, 

You don't know what it is like, being an addict. Neither of you do.

That's if his spouse is sober. 

Neither of you know what it is like being an addict! 

(I repeat) 

This theoretically justifies the behavior that the therapist or the spouse is calling out. Saying You don't know what it's like is saying, You can't empathize (so I'm right AND you're ganging up on me!).

The addict's response can be so emotional, so angry, so full of pathos, that it is hard to not have a sympathetic reaction. After all, it is a poor me calling out, Poor Me! And nobody likes to be kicked when they're down. But for someone in recovery life really is a lot of work, it takes tremendous self-discipline and mindfulness to avoid the many behaviors that give the word addict a bad name.

Been down so long it looks like up to me is not just the title of a Richard Farina novel. 

Richard Farina' famous novel, 1966

I want to say to my screaming patient, for his voice feels very loud,  'Are we done, now?' 

Because it was more than the voice. Spouse and I witnessed facial contortions and fist clenching. Drama.

I want to ask this, Are you done now? as I would a child, but his spouse is there and I don't want to shame him. So rather than attend to the drama I turn to the spouse and ask her how she's been doing. She explains to me that she has been under a tremendous amount of pressure from her parents who want her to help them with her grandmother. Her parents both work, she works, but her hours are flexible.

Her spouse jumps in to say how dysfunctional that is, and that he has been saying that she should just say NO! He is adamant about this, tells her that her parents are toxic alcoholics and she should not be doing what he considers her mother's job. He maintains that his in-laws have a way of making his wife feel guilty. They can make her, a grown woman with a choice, comply, do what they want. That makes him feel unappreciated, unloved, abandoned, and less-favored. 

So he drinks. Or he has recently.

She (pointing to his spouse) makes me do it, he asserts. 

He has been in AA for fifteen years so it is difficult to allow the avoidance of responsibility to go unnoticed. I remark upon this. I gently say, 'I thought that an addict, no matter the external circumstances, takes responsibility for a slip.'

Much double talk ensues, ultimately agreement with the above, but also a reminder that SHE MADE ME DO IT.

To which I reply. So you have work to do. 

Yes, of course. But she could make it easier.

Can she? And then what, let's say she can't make it easier? It is tit for tat, you abandon her to alcohol? 

Fifteen years, it goes without saying, isn't always enough. 

She tells him she will turn her mother down. She doesn't want to babysit her grandmother, it turns out. All she wanted to do was be the one to make that decision, without any coercion from anyone. 

It usually works that way. 

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