Robert Coles(1964) observed that crisis can lead to growth when it presents an opportunity to confront impediments to further development. This is exactly what the female partner is confronted with when in a relationship with a male alcoholic. This is a time of great personal assessment. Since in the period of Recovery, all attention for the alcoholic needs to be on maintaining abstinence with time devoted at a much later period to work in depth on the relationship issues, this is a prime time to explore in an in-depth way the core issues of the female spouse(Brown,1999).
There should be a focus on core issues with the goal of resolving them when possible. According to Whitaker(1991) a core issue is one that comes up repeatedly, such as issues around control; trust: being real; identifying and owning feelings; low self esteem; depression; grieving ungrieved losses, and fear of abandonment. Also included are all or nothing thinking; high tolerance for inappropriate behavior; over responsibility for others; neglecting one's own needs, and having difficulty resolving conflict and difficulty giving and receiving love.
Encouraging the reading of material on codependence is always helpful especially when the client is so inclined. Two books that would be included initially are "Codependent No More," by Melody Beattie and "Boundaries and Relationships," by Charles Whitfield.
Encouraging empowerment in the client as a woman is very important. It would be most helpful to have her listen to her own inner guide, who knows and understands all that has happened in her life, and who is wise, compassionate and loving towards her. Many times the use of guided imagery to help her connect with this part of herself is extremely helpful. She can learn to trust those instincts and gut feelings about herself and situations in which she finds herself. It may also be helpful to encourage her to listen to her physical symptoms and to examine what they are saying to her. Her symptoms may be suggesting to her that they are healthy reactions of her self system to situations of inequality, powerlessness, coercion, fear and anger. Such symptoms as headaches, overeating, fatigue and depression can be listened to as powerful and helpful messages from the inner self. It is also very important to teach the client how to say No and understand the reasons why this has always been difficult for her. Teaching the client to be a self observer in a variety of situations that have proved to be very uncomfortable for her and to work on more effective ways to manage such situations. It is helpful to observe how many times there is an automatic need to explain one's behavior no matter what the situation and to take this and develop increased understanding about this behavior so that change can be made. It is important to focus on taking care of oneself mentally, physically and spiritually. The teaching of relaxation techniques, the use of relaxation tapes, the teaching of self-hypnosis and the use of biofeedback all work well in this area. Developing a clear understanding of the toll prolonged stress takes on the mind and the body is also vital. With this understanding, helping the client develop a self management program including regular time out for relaxation, the use of mindfulnesss, focus on good nutrition and exercise is very important as is following through with regular physical exams.
Journaling about one's feelings and experience is also very helpful in recognizing feelings and understanding them. This is especially helpful for the codependent female.
It is important to challenge the client's belief system by asking her exactly where she learned that she is responsible for making other people happy. Or: who told her that she could not ask directly for something that she wanted? It is good to explore within her own family where the expectations for women arose. It is also very helpful to explore underlying beliefs of which the client may be unaware. For example, "you act as though your needs are completely unimportant" or "it sounds as if expressing your anger is bad". It is also helpful to assist her in seeing the power imbalance between men and women and to understand the impact this has on her behavior. Lastly, it is helpful for many clients to explore their spirituality and to come to their own balanced decision about what is best for them at this pivotal period of growth. In conclusion, the female partner of the male recovering alcoholic is in a place not only of much stress and discomfort, but is also where, if she is given the best direction in therapy, she can travel with her recovering partner along the path of mutual growth and genuine healing.