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Stop Being a Victim!

A 10 Step Guide to Rescuing Your Marriage to


an Alcoholic
__________________________________________________________________

!
!"#$%&'()**! +,,-*./%&)/*0(%1*2343*
!!

From the Grumpy Spouse Series: Book One

Stop Being a Victim!
A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic

Warning: DO NOT READ this book if you want to change
your spouse, but not yourself!


by Sarita Uhr, M.D.







Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
"!
Stop Being a Victim!

Ten Steps To Rescuing Your Marriage to an Alcoholic


Ist Edition Copyright 2009 by Sarita Uhr, M.D


Legal Notices


No part of this publication may be reproduced without written
permission from the author except for brief passages which may be
used by a reviewer. Copying by any means including electronic
methods, selling or hiring, transmission by voice, electronic mail,
posting to a Web site or uploading to an ftp site or CD duplication is
strictly forbidden. Legal action will be taken against offenders.


Published by:
Sarita Uhr, M.D.
14785 Preston Road, Ste 550
Dallas, Texas 75254

LEGAL NOTICES:

The Author, his publishers, agents, resellers or distributors assume
no liability or responsibility to any person or entity with respect to
any loss or damage alleged to be caused directly or indirectly by the
use of and the advice given in this publication.
It is recommended that users of this publication seek medical or
other independent professional advice if treatment seems necessary
before acting on any of the advice in this book. This book is not
intended as a substitute for medical advice from a qualified
physician. The intent of this book is to provide accurate general
information in regard to the subject matter covered. If medical
advice or other expert help is needed, the services of an appropriate
medical professional should be sought. This book does not
guarantee your family member will be saved from his or her drug or
alcohol abuse or that your marriage will be saved

Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
#!

Disclaimer


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:"@#9=)=*9&6)3*





Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
$!
Introduction

Dr. Sarita Uhr is a psychiatrist, educator, writer, and speaker. She treats
professionals and their family members for anxiety, depression, and addiction.
She specializes in finding the right combination of medications to get people on
track. Her psychiatry training and fellowship in psychopharmacology at
Stanford University School of Medicine has made her an expert in this area.

During her training, she was taught by the foremost leaders in the field of
psychiatry. In addition to learning psychotherapy, she received special training
in clinical and laboratory research where she gained an advanced understanding
of how the psychiatric medications work. She is well versed in cutting edge
research on anxiety, depression, and addiction. Her academic background
coupled with twenty years of clinical experience puts her in a unique position to
determine the needs of her patients. She is respected by her colleagues for her
ability to balance medication management with talk therapy and lifestyle
changes. She specializes in treating addiction.

Dr. Uhr has over 40 published articles including, Anxiety and Depression, Is
Medication the Answer? , The Addictive Personality: Why Some People Get
Hooked, and Combining Psychiatric Drugs to Beat Depression. Her speaking
topics focus on the impact of stress on our mental and physical health.

Dr. Uhr graduated Phi Beta Kappa from Pomona College in Claremont,
California. She attended medical school at the University of Texas Health
Science Center in San Antonio where she later served as an Assistant Professor
of Psychiatry. She completed her psychiatry training and a fellowship in
psychopharmacology at Stanford University School of Medicine in Palo Alto,
California. Dr. Uhr is in private practice in Dallas, Texas.



Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
%!

Dear Alcoholic,
I have learned a lot about your disease from the many people I treat who
suffer from addiction. Many of you are wonderful individuals. Some of you
are very sensitive and find it difficult to handle the curve balls life throws
at you. Some of you feel vulnerable as though you have no buffer or filter.
Many of you are charming, colorful, and fun. Maybe you never learned the
coping skills to help one face life head on. Some of you find it easier to
push conflicts under the rug. With others, pride and ego may get in the
way. Some of you like to be in control and like to be right. Many of you
dont trust easily. Some of you feel hurt and vulnerable and are holding a
lot of feelings inside.

Each of you has his/her story and each story is unique. You are in a battle
with your own brain. Your spouse feels like a victim to your problems and
in many ways, you are a victim, too. You are a victim of your addiction
which is a medical disease.

You may equate having a problem with anything to losing everything.
Your first step will be the hardest which will be admitting that alcohol
controls you rather than vice versa.

My goal is to save your marriage, not dissolve it. By the time your spouse
needs this manual, there is not enough room in the marriage for both your
spouse and alcohol. Your spouse is feeling that you value alcohol more
than the family.

Lets figure out together how to change this so that everyone wins. I am
on the side of the marriage surviving, but your spouse cant do this
without your help.



Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
&!

Dear Spouse of an Alcoholic,
Do you feel that you are a victim of your spouses drinking? Do you feel
you come in second to alcohol or that your wants and needs arent that
important to your spouse any more? Do you remember how much better
things were before alcohol took your spouse away from you? Can you
remember the core of that love you had for your spouse before it got
covered up in resentment, anger, and fear? Are you the one sinking all the
effort into saving your marriage, but your efforts seem futile?
I want to help you turn things around, but it means giving up your old
ways of doing things.
I also want to educate you about alcoholism so that you understand what
your spouse is up against. Your spouse has a medical illness, alcoholism.
He/she is at war with his/her own brain. The brain has ammunition to use
against him/her. With appropriate treatment, your spouse can improve
his/her fighting prowess to help win against his/her brain. He/she
needs your compassion, not your anger.
If you can admit that you need changing too and that it is not only your
spouse that needs to change, I can help you! Read on and good luck!













Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
'!

Ten Steps to Rescuing Your Marriage to an
Alcoholic
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Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
(!
Is your spouse an alcoholic?

When you accuse your spouse of drinking too much, he/she probably
denies having a problem with alcohol. If you argue with your spouse,
he/she probably blames you or stress for the need to drink. Your spouse
says it is the only way to relax. You wonder, Is he/she really an
alcoholic?
In Step 1, I list the general medical used by psychiatrists to determine if a
person has a problem with alcohol abuse. Abuse means the person is
drinking to excess.
Next, I will list the medical criteria for alcohol dependence. This is the
term used to describe alcoholism.
I am not sure how useful or important it really is to distinguish between
alcohol abuse (excessive use that is mild on the drinking spectrum) or
alcohol dependence (excessive use that can be considered severe). It is
important to understand that there is a spectrum of mild to severe
symptoms, like most illnesses.

PROCEED TO STEP 1









Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
)!
Step 1: Assess if your spouse is an alcoholic

Warning Signs of Alcohol Abuse
Is your spouse unable to stop drinking after one or two drinks?
Is your spouse drinking everyday or, if not, is he/she binge drinking on
weekends?
Have you asked him/her to quit drinking and noticed he/she is unable quit
or cut back on the number of drinks he/she consumes?
Are you worried he/she will get in a car accident when drinking or get
pulled over by the police?
Has his/her job suffered because of his/her drinking?
Is he/she not taking care of his/her daily responsibilities (household
chores, taking the kids to school, getting to appointments on time etc.)?
Has he/she suffered physical consequences from drinking alcohol such as
blackouts, liver problems, pancreatitis, or seizures?

Warning Signs of Alcohol Dependence
Have you noticed your spouse needs increasing amounts of alcohol to get
the effect he/she wants (i.e. feeling intoxicated)?
Does he/she continue to drink despite his/her knowledge of all the
negative consequences (i.e. marital strife, physical consequences, risking
an accident when driving under the influence of alcohol, risking legal
consequences, risking job, etc)?
If he/she quits abruptly or lowers the amount he/she drinks too quickly,
does he/she experience withdrawal symptoms such as shaking,
sweating, insomnia?
Has he/she tried to quit, but have not been successful?

Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
*!
Learn about the disease
Alcoholism is a medical disease. It is not a sign of weakness or poor
willpower. People who are very judgmental about addiction (ex: Whats
wrong with him, why doesnt he just stop drinking) do not understand the
medical basis of the disease. Scientific research on the brain in the last
10 years has shown that alcoholism has both a genetic and biochemical
basis. Many people are not aware of this and/or do not understand how
serious and life threatening the illness is. Many doctors are not up to date
about the latest addiction research and share some of these old
judgmental attitudes!
Step 2 will guide you through the statistics about alcoholism. Your
awareness of these statistics will strengthen your resolve to take action.
I will then guide you through an easy to understand lesson about what is
happening to the brain when it becomes addicted to alcohol.
I will outline, in laymens terms, the scientific basis of cravings and
compulsions that are the main cause of an alcoholics irrational
behavior. I will give you a clear explanation of how the primitive brain
rules over the alcoholic as opposed to the more sophisticated, modern
brain. At the end of Step 2, you should come away with a more
compassionate view of what your spouse is up against (battling his own
brain). PROCEED TO STEP 2



Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
"+!
Step Two: Get Educated about the Disease
Learn Facts and Statistics about Alcoholism

Alcohol abuse is a progressive and potentially life threatening disease.
8.5% of adults in America, 17.6 million people, 1 in 12 adults meet the
medical criteria for an alcohol use disorder.
18-24 year olds have the highest rate of alcohol abuse.
Men are three times more likely than women to abuse alcohol.
In a recent study, even low levels of drinking alcohol in women raised
cancer rates.
Alcoholism runs in families. There is a genetic component to the disease.
If a parent is an alcoholic, their child is 50-60% more likely to develop an
alcohol use disorder than a person whose parents are not alcohol
abusers.
Any one who drinks frequently can become an alcoholic.
External factors may contribute to alcohol abuse such as losing a job, a
spouse, or self-medicating anxiety with alcohol.
100,000 people die each year from alcohol related deaths.
Alcohol reduces life expectancy by ten to twelve years.
Someone dies in an alcohol related car crash every 31 minutes.
Alcohol abuse is a global problem and crosses all economic groups.
Alcohol abuse has significant mental and physical effects.
The longer you stay sober, the better chance you have of remaining sober.
Recovery from an alcohol use disorder is characterized by both periods of
sobriety and periods of relapses (90% chance of a relapse over 4 years).
Roughly, 7 drinks a week for women and 14 drinks a week for men can
produce alcohol dependence (see ,-.!/0123405!64712181.!34!95:3-35!
9;87.!04<!95:3-3527=!>82<.524.7!in the Resource Section at the end).

Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
""!

Sex Number of Drinks/Week
Men 14
Women 7




Potential Consequences of Excessive Drinking
Loss of job
Loss of marriage
Increased incidence of depression and anxiety
Loss of physical health ( ex: heart and/or liver problems)
Increased cancer rates in women
Decreased life expectancy
Loss of nerve cells (shrinkage of the brain)
Legal consequences (DUI, DWI)





Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
"#!
Step Two: Get Educated about the Disease
Understand How Alcohol Affects the Brain

The effects of alcohol on the brain (central nervous system) are very
complex.
Alcohol is a central nervous system depressant. It depresses or quiets
the brain and can contribute to depression.
The brain is made up of billions of nerve cells called neurons.
Neurons communicate by chemicals and electricity. The chemicals are
called neurotransmitters (chemical messengers).
The neurotransmitter, which plays the main role in alcoholism and other
addictions, is called dopamine.
Dopamine is involved with the reward system of the brain. Increased
dopamine leads to a feeling of pleasure or euphoria.
We experience a natural high when our brain releases dopamine in
response to winning a tennis match or getting a standing ovation at a
performance.
Drinking alcohol leads to increased dopamine release (an artificially
produced high) in the brain. More dopamine release means more
pleasure.
Other neurotransmitters are involved in alcohol use disorders namely
GABA (which inhibits our impulses), glutamate (which excites our
brains), serotonin, and norepinephrine. The latter two have effects
though out many different areas in the brain.




Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
"$!
Step Two: Get Educated about the Disease
Understand How Alcohol Affects the Brain

Over time, with excessive drinking, the brain gets depleted of dopamine.
The brain, biochemically speaking, is shouting, Where is the
dopamine, get me some dopamine! The brain creates a craving ,
an urge , a drive which encourages the person to get dopamine
(drink alcohol).
Many alcoholics complain of depression, boredom, agitation, or
restlessness. These mood states may represent the brains urging to
seek dopamine.
Over time, the brain adapts to repeated exposure to alcohol by lowering
its own production of dopamine (called neuroadaptation).
The addict, by drinking alcohol, provides the brain with an external
source of a substance that causes the release of dopamine. In other
words, from the brains point of view, Why bother putting money in the
bank (making dopamine) when I can rob a store and get what I need (i.e.
drink alcohol)? The brain comes to rely on this external source of
dopamine.


Neurotransmitters affected by alcohol

Dopamine
Serotonin
GABA
Glutamate
Norepinephrine


Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
"%!
Step Two: Get Educated about the Disease
Learn About Cravings and Compulsions

Addiction is characterized by cravings and compulsions.
Cravings refer to the strong urges to use a substance that your brain has
become dependent on.
Compulsions refer to the repetitive behavior an addict uses to obtain the
substance (get drunk).
Alcohol Dependence is when your brain is yelling (figuratively speaking,
of course), Where is the dopamine, where is the dopamine?
Rational thoughts are blocked as the brain is obsessed with its goal of
getting more dopamine (alcohol).
An addicts denial of the addiction and the lack of control over drinking
seems crazy to the non-addict spouse, who thinks, Why doesnt he/she
consider the consequences of drinking alcohol (such as a DUI)? Maybe
the addict has even gotten an advanced educational degree like an
M.D. or Ph. D. How can he/she trade this past ability to delay
gratification for the irrational drive for the immediate gratification that
several drinks provide?
Why? The primitive part of the brain is driving the relapse.
Our ability to plan is ruled by the cortex of the brain; the outer layer.
Humans have the thickest cortex of all mammals. The cortex is the
mammalian part of the brain which has been the most recent to evolve.
The primitive part of our brain is situated deeper inside. Structures
such as the amygdala, hippocampus, and midbrain form connections
known as the mesolimbic dopamine pathway which make up the
reward circuit. This is the reptilian or primitive part of our brain.


Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
"&!
Step Two: Get Educated about the Disease
Learn About Cravings and Compulsions

When the brain demands more dopamine, the primitive part of the
brain rules over the cortex (therefore you do not think before you act).
The addict, over time, can be viewed as mere primitive organism
whose main instinctual drive is to get dopamine.
The reptilian brain produces cravings (these may take the form of
restlessness, sadness, anger), which drives the dopamine-depleted
brain into the compulsion (getting the fix). Cravings override the ability
to delay gratification or use rational judgment (mammalian brain). The
vicious cycle of craving and compulsion continues.



Reptilian Brain Mammalian Brain
Most primitive Most recent to evolve
Deep in the brain Outer layer of the brain
Drives relapse Higher level thinking







Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
"'!
See the marriage from a fresh perspective
All of us tend to focus on our own point of view when a situation triggers
strong emotions. It is key to learn how to see things from your partners
perspective. In other words, what is your partner feeling? This
understanding enables you to change your reactions to his/her behavior.
As a spouse of an alcoholic, you feel so angry and frustrated that your
negative feelings color all aspects of your marriage. You and your spouse
get in a vicious cycle of arguing and then withdrawing. Negativity
breeds negativity.
What are your complaints, frustrations, and worries in the marriage?
Conversely, what are his/her complaints, frustrations, and worries?
Step 3 tells you how to view your marriage from both sides. It also
outlines the personality traits of both you and your partner. As a couple,
you are like two pieces of a jigsaw puzzle that fit together. Your
personality traits complement one another. You attract an alcoholic.
Why?

PROCEED TO STEP 3 (to find out why)










Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
"(!
Step 3: See the marriage from both sides
The Non- Addicted Spouses Complaints, Frustrations, and Worries

Its how he treats me when he has been drinking that bothers me the most.
She lies a lot and I dont trust her. I know she is cheating on me.
I dont know if he is coming home for dinner or not coming home at all. Has he
gotten a DWI or has he been in a car accident?
Do I pretend to be asleep when he comes in at 4AM?
I cant depend on him anymore.
I never know what to expect with her moods.
He never thinks about my feelings any more.
He doesnt participate in the marriage or family any more. I do it all.
She gets defensive if I ask her about her drinking.
He embarrasses me and makes inappropriate remarks.
He argues and fights with me.
She isnt intimate emotionally or physically any more.
He doesnt think he has a problem with alcohol.
Sometimes he is quiet and seems down.
She is self absorbed.
He is spending too much money.
He is late for work when he is hung-over. Will he lose his job?
She expects me to cover up for her about her drinking.
What would I do without him? What would my future be like?
I do so much for our him and our family and I dont feel appreciated.


Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
")!
Step 3: See the marriage from both sides
The Addicted Partner Often has the Following Personality Traits:

Selfish and self absorbed.
Impulsive (doesnt think things out. Cant delay gratification such as
buying a car or changing jobs).
Procrastinates (any alcoholic I have treated puts things off instead of
dealing with situations right away).
Lies and makes excuses for things instead of taking personal
responsibility.
Overly sensitive (uses alcohol to anesthetize themselves from any
emotional pain or fear).
May have a history of physical or sexual abuse in their childhood.
Experiences anxiety and worry and uses alcohol to self medicate.
Easily frustrated.
Perfectionist.
Problems with intimacy. Problems with authority. Defiant. Likes control.
Easily bored, restless, and discontent.
Seeks stimulation of some sort all the time.
Cant sit still and relax without drinking.
Easily angered. Gets angry out of proportion to what the situation
warrants.
Minimizes the importance of most situations (has incredible capacity for
denial).
Feels different than other people and doesnt fit in.
Poor coping skills. (Relies on alcohol as a crutch to get through stress).
.


Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
"*!
Step 3: See the marriage from both sides
The Addicts Complaints, Frustrations, and Worries about his Non-
Addicted Spouse

All she cares about is my drinking. Every positive thing I do doesnt seem to
count like providing for my family, fixing things around the house, and trying to
be supportive.
My spouse nags me.
She is always depressed. She doesnt support me. She gives me the cold
shoulder when I come home. Why would I want to go home to that?
I dont think I have a big problem with alcohol. My spouse exaggerates it.
She cant stop me from drinking and I dont want to stop.
He tries to control me.
I feel guilty when I hide my drinking and lie to cover it up.
I know I have made some bad choices. She doesnt understand how hard
things are for me.
I feel bored and restless.
If I hadnt been drinking, I would have been more successful.
I know I spend too much money.
Im embarrassed to face my family when I have been drinking.
I feel desperate and dissatisfied with everything.


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Copyright ! 2009 Sarita Uhr, M.D.
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Step 3: See the marriage from both sides
The Addicts Complaints, Frustrations, and Worries about his Non-
Addicted Spouse

I feel unhappy with my wife and my job.
Will she take the kids and leave me?
He gives me the cold shoulder when I have been drinking.
She wants me to stop drinking, but it is one of my few pleasures.
I am not sure I can stop drinking, even if I want to.
Knowing all the negative consequences from drinking has never stopped me
from having a drink when I really want one.
I feel guilty that my kids pick up the slack for me.









Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
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Copyright ! 2009 Sarita Uhr, M.D.
!
#"!
Step 3: See the marriage from both sides
The Non-Addicted Spouse Often has the Following Personality Traits:

Weak sense of self.
Comfortable with the martyr role (many grew up with an alcoholic parent or
parents that didnt meet their needs).
Has intimacy problems and fears abandonment.
Bottles up their feelings (poor communicators).
Has difficulty reaching out for help.
Overly responsible and takes on more than they should.
Distrustful.
Mixes up being needed with being wanted (will take on role of a
caretaker to become indispensable to their partner).
Low self esteem.
Avoids confrontation (their needs have never counted so they are not
comfortable asserting themselves).
Wants to be appreciated by their partner for rescuing them.
Does more than their fair share to make them feel invaluable to their
partner.
Feels empty inside and obsesses on their partners behavior to avoid
facing this feeling.
People pleasers.
Ignores their gut feelings.
Allows their fear of being alone to dominate everything.




Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
##!
Learn to understand yourself and your choices
Are you at the point where you are too embarrassed to tell your own
family and friends what really goes on every day?
Let me guess.
Is he late for work?
Does she rely on you to get her up in the morning?
Do you lie to his boss about his absences?
Is she cheating on you?
Do you have to make excuses about him to your own children?
Do you have to pick up all the slack of every day responsibilities?
You dont want to tell any one these things because you know how they
would respond.
LEAVE!
To every one else, its a no brainer. Most people cant imagine putting up
with this kind of life. That is why alcoholics tend to find the jigsaw piece
that fits with their needs.
Life is hard. You have your needs too.
Step 4 guides you through the reasons that you stay in your marriage.
It will give you a clear understanding of your psychological make-up. I
will outline for you your specific fears and needs.
You must understand your own fears before you can face your fears and
be willing to change.

PROCEED TO STEP 4



Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
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Step 4: Understand why you stay in the situation
Your Fears: Why Do You Put Up with This Rut?

Your friends and family who know about the situation think you should leave
your spouse. They think you are crazy to put up with his/her behavior. Your self-
esteem suffers because you are choosing your partner (by staying in the
marriage) and your partner is choosing alcohol over you. You love your
spouse and he/she loves alcohol. Whats wrong with this picture?
The shocker is: You are addicted to him/her the way he/she is addicted to
alcohol.
Think about it. You obsess about /her behavior the way he/she is obsessed
with drinking. You try to control his/her behavior. You try to change your
spouses thoughts and feelings. You cant stop focusing on your spouse and
his /her behavior despite the fact it is driving you crazy (ex: doesnt come home
on time). You may even experience anxiety symptoms such as a tight chest,
rapid heartbeat, insomnia, changes in appetite, or feelings of depression in
response to your situation. These are the same symptoms an addict may
experience when he/she is in physical withdrawal from a substance! You may
even have become addicted to pain pills or started anti-anxiety medication
in an attempt to cope with this marital stress. You deny how bad your marriage
is and rationalize why you stay (When its good its good even though when
its bad, its really bad. I wouldnt leave him/her for cancer, would I? How can I
consider breaking up our family when he/she has a disease?). You have even
lied to family, friends, coworkers, and bosses to cover up your situation. You
are protecting your family secret. You compulsively take care of everything
for him/her and your family. You say you are the stabilizing force. Does any of
this sound familiar? You are experiencing ADDICTION!

Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
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#%!
Step 4: Understand why you stay in the situation
Your Fears: Why Do You Put Up with This Rut?

The bottom line is very painful to face:
You are as sick as your spouse.
I know that really stings to read that sentence.
You are codependent. You and your partner depend on each other to fill
different needs: his/her need to drink and your need to rescue.
All along you have been thinking, Hes /shes the one with the problem, not
me.
Let me explain why you are in this pickle. Its easier for you to focus on
another person than yourself. Why?
Lets start with your fears...
Here are some examples of big fears:
Abandonment, rejection, intimacy fears, loss of lifestyle
(ex: may have to get a job), loss of having his/her children
everyday if there is a divorce, and fear of the alcoholic
spouses ability to take care of the children in the case of
divorce.



Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
#&!
Step 4: Understand why you stay in the situation
Your Fears: Why Do You Put Up with This Rut?

These are examples of some common fears that may drive a person to try to
fix someone at his/her own expense. Is it worth it? Why would any one being
willing to sacrifice the quality of his/her life for another?
Here are some potential reasons why: Maybe you grew up in a family that did
not meet your emotional needs. Maybe you did not feel valued for who you
are. Maybe you grew up with an alcoholic or a parent that was so self-absorbed
or busy (working or taking care of a sick brother or sister) that he/she did not
give you the nurturing, warmth, and attention that you needed and
deserved (and that you still deserve). Maybe you were overly responsible as a
child to make up for an irresponsible parent and you are used to a caretaker
role. Maybe you crave love because you have never gotten enough. Maybe you
mix up love with dependence (being needed) by becoming superman or
superwoman and taking care of everyone, but yourself. You may have put
incredible effort into being a caretaker of your spouse and rescuing him/her in
order to get the goodies (his /her attention and love). Maybe you need a pat
on the back or external validation of what you can do for someone in order to
boost your self esteem rather than recognition of the wonderful person you are
with good values and a good heart. Maybe your ultimate fear is that if you are
not needed, you will not be wanted. Your value has become what you
provide, not who you are. Maybe you are afraid this defective relationship
is actually the best you can hope for, that no one else will ever want you.
Maybe you have learned to push your feelings under the rug and avoid
confrontation so he/she will not get angry with you and abandon you. These are
some reasons, but you may have others that are unique to you

Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
#'!
Step 4: Understand why you stay in the situation
Your Fears: Why Do You Put Up with This Rut?

You may be terrified of being alone and unloved. At some level, it feels, like
you could just die. Maybe it feels like all the oxygen will be sucked out of you if
you let go of your partner, as sick as he/she is. Your spouse is like your
lifeline. Its an illusion! Not a good or healthy feeling to be tied to a drowning
person, is it?
With all your efforts, you are actually enabling your partners addiction to
continue! You take care of your spouses every need and more. You do all the
chores, are mother and father to your kids, take the kids to school when he/she
is hung-over, lie to his/her boss and to your friends when he/she doesnt show
up, and on and on. You put up with lies. Your spouse never has to face the
negative consequences of his/her addiction. You protect your partner from it.
In doing this, you disable him/her!
What can you do to change this?
Stop rescuing him/her!
Support your spouse in his/her own independence.
Assert yourself more.
Focus on taking care of you.




Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
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Copyright ! 2009 Sarita Uhr, M.D.
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#(!
How is your spouses alcoholism affecting you and your
children?

Most people in your situation rationalize the impact of their loved ones
addiction on themselves and their children. Addiction destroys
families. Every one is affected at a deep level.
Both spouses suffer a lack of intimacy. Basic needs are unmet. You feel
isolated and alone. Your needs do not count. You feel unlovable and
unworthy. Your self-esteem is shot.
The children feel it is their fault that they arent worthwhile enough
for the addict to overcome his/her addiction and be available as a
responsible parent. They grow up with a poor self-image, anger, and
resentment. These feelings lead to life long problems.
In Step 5, I outline the different problems that arise from your spouses
alcoholism both on you and your children. This step will help break
through you denial of how serious your situation has become.

PROCEED TO STEP 5









Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
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Copyright ! 2009 Sarita Uhr, M.D.
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#)!
Step 5: Face the impact on the family
The Impact: Family Fall-Out

The impact on the spouse of an alcoholic includes:
Loneliness and isolation.
A lack of emotional intimacy due to poor communication.
Resentment and anger.
Verbal abuse.
Possible physical and/or sexual abuse and fear for his/her safety and/or
the childrens safety.
Lying for his/her spouse in order to keep the family secret.
Increased responsibility for the house and the children because he/she
cant depend on his/her spouse.
Depression and anxiety (What would you expect if you were trapped in
that situation?).
Low self esteem.
Not functioning well at work because of distress over the marriage.
Inadequate sexual intimacy.
Physical health problems due to constant stress in his/her personal life
and not getting enough sleep or eating well.
Financial consequences of his/her spouse not working, spending too
much, or using his/her money for legal problems such as arrests for
drunk driving.
Guilt that the children are deeply affected by this stressful situation.



Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
#*!
Step 5: Face the impact on the family
The Impact: Family Fall-Out

The impact on the children of an alcoholic includes:
Problems with trust and feelings of insecurity as a result of living with
someone who is unpredictable and unreliable (intimacy issues).
Feelings of guilt that they are responsible for their parents disease.
A constant need to lie for their alcoholic parent to keep the family secret
(pretending to be a normal family).
Low self esteem (its hard to feel valued when your parent loves alcohol
more than you).
Higher rates of their own substance abuse, depression, anxiety, and eating
disorders compared to children growing up in non-alcoholic families.
Not as successful in school (less likely to go to college).
Feelings that they are different and therefore tendency to become isolated.
Fear of shame and embarrassment that their peers will discover that they
have an alcoholic parent. They dont invite friends over to the house.
A greater risk of being physically or sexually abused by the alcoholic
parent than children growing up in household without an addict.
Increased responsibility around the house compared to children of non-
alcoholic parents. For example, older siblings are often seen taking care
of younger siblings needs to an excessive degree.
Picking dysfunctional partners for marriage whom they play a caretaker
role with. They are used to this role from childhood.
Higher rates of being born with Fetal Alcohol Syndrome (FAS) if the mother
drinks alcohol during pregnancy. Alcohol hurts the developing fetus. A
baby with FAS is born with facial abnormalities and brain damage.

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Copyright ! 2009 Sarita Uhr, M.D.
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$+!
Quit trying to control your spouse
You have tried every thing you can think of to make him/her stop
drinking. Let me guess? Not only has it not helped, the situation is getting
worse. No matter how angry, dramatic, or cold you act toward your
spouse, he/she continues to drink. You have even gotten him/her to
promise to cut back or stop drinking, but have not seen any results. You
can cut the tension in your house with a knife. You cant even
concentrate at work or on other things at home because you are always
wondering what trouble he/she is getting into now. You dont believe
anything your spouse says. You have become the worlds expert at being
a snoop and catching him/her in different lies. Have your attempts
gotten you anywhere? You once thought of yourself as a relatively
normal person. What do you think of your own behavior now?
Crazy?
Step 6 will identify the approaches you have tried that are making the
situation even more unbearable.

PROCEED TO STEP 6





Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
$"!
Step 6: Learn to give up on useless strategies
Ten Strategies That Have Been Ineffective in Improving Your
Marriage (Trying To Change Your Spouses Behavior)

1. Arguing (which leads to bad feelings).
2. Ignoring the problem in hopes it will improve on its own (it never does).
3. Withdrawing or acting cold (emotional punishment which is passive
aggressive).
4. Trying to control your his/her behavior (checking your spouses cell phone,
taking car keys away, following him/her in order to expose a lie).
5. Being needy (thats the quickest way to get your spouse to avoid you).
6. Blaming (stop holding him/her responsible for your feelings of anxiety and
depression over your family situation. You are choosing to stay. Think about it
again and ask yourself- who is the one with the problem?).
7. Instilling guilt (dont bring up that the kids do not invite their friends over.
Dont focus on how much money he/she could have made).
8. Giving them a false ultimatum (dont threaten to leave him/her if you are not
going to follow through).
9. Whining and complaining (UGH! Who can stand to be around a whiny
baby?).
10. Bailing them out of situations (dont cover up for his/her irresponsible
behavior or you are actually delaying their recovery). Quit rescuing!


Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
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$#!
Learn to be the solution, not the problem
Without realizing it, you have contributed to the problem. You want
your marriage to improve, but cant figure out how to reach this goal.
You feel helpless. You are scared if you let go of your attempts to control
your situation that you will lose everything! You are terrified of ending
up alone. It feels as though you have no lifeline and nowhere to turn. Its
scary to change your approach, but your old ways are clearly not
working. You have no choice, but to try something different. Step 7 will
give you new strategies to implement that will turn your life around.
Your life and your marriage have the best chance of improving with
these proven techniques.
Be brave. Ask for help. This is very often something you cannot do
alone. Some people go to a support group such as Al-Anon, Family
Anonymous, or Alateen. Some people go to a therapist or a
psychiatrist. Get the guidance and support you need to carry out the
strategies outlined here.
PROCEED TO STEP 7







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Copyright ! 2009 Sarita Uhr, M.D.
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Step 7: Learn new helpful strategies

Ten Effective Strategies that will Help Improve Your Marriage (Trying
to change your own behavior)

1. Focus on yourself, not your spouse. You can change yourself! Your
behavior is something you can and should control.
2. Get your own life going! Pursue an interest, take a class, or participate in a
sport. Have fun. Start working out. Enjoy your job and your children. Call a
friend. Quit obsessing about everything your spouse is doing. All your energy is
focused on your spouses problems. This obsession is toxic to you.
3. Reach out for support. Call a close friend. Tell your family what is going on.
Reconnect with a college friend. Start building a support system. Go to Family
Anonymous or Al-Anon.
4. Work on being independent. No spouse can meet all of your emotional
needs. Its not healthy. Learn to rely on yourself and your support system. Again,
make new friends, reach out to extended family, and/or even go to therapy.
Pursue new activities. Learn to stand on your own two feet.
5. Let your spouse experience the consequences of his/her addiction. Let
him/her be late for work. Let your spouse miss an important event for one of the
kids. Dont make excuses or lie for him/her. Quit policing: his or her every
move.
6. Show empathy. When your spouse is stressed, let him/her know you are
aware of this. Acknowledging your partners stress doesnt make him/her abuse
alcohol. Your spouse is fighting the primal urges produced by his/her brain.

Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
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Copyright ! 2009 Sarita Uhr, M.D.
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$%!
Step 7: Learn new helpful strategies
Ten Effective Strategies that will Help Improve Your Marriage (Trying
to change your own behavior)

7. Dont use your new independence as a weapon against your spouse.
As you concentrate on changing your own life, you will not be so dependent on
him/her. Your partner will feel this change. As you develop a better balance in
your own life, you will feel less angry and find it easier to be nice to your spouse.
8. Go to activities without your spouse. Go to the movies with a friend. Go to
Church even if you feel self conscious about your spouses absence. Go away
for a weekend with friends. Quit pretending to the outside world that you are the
perfect family or couple.
9. Take responsibility for your part of the problem. Quit acting like you are
the one without the problem in the family. The problem could not have
continued this long without your enabling/rescuing your partner.
10. Be up front about your feelings. Dont bottle up your feelings and let
them fester or you will explode when your feelings finally come to the surface.
Learn to communicate in a constructive way when things bother you and this
will save you loads of time and trouble. Consider going to therapy to learn this
skill. Be more assertive. Take better care of yourself emotionally and physically.
11. If all else fails, and your partner is not willing to get help, evaluate your
options. If your children or yourself are in physical danger, you must consider
leaving the situation. Protecting your life or your childrens life comes first!



Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
$&!
Learn how an intervention works

For every reason you bring up to your spouse to stop drinking
excessively, he/she will give you an excuse for his/her behavior. This
powerful denial is a core feature of alcoholism. Without confronting your
spouse with the consequences of his/her disease, he/she will never get it.
Your spouse views you as the one with the problem. You are the nag
that causes he/she to drink more. You feel like you are beating your head
against the wall. What are you supposed to do?
Organizing an intervention is a common method used to penetrate
the denial that accompanies addiction. An intervention is a very
intricate and emotional process that is best guided by a professional.
If the process fails, it often makes the situation even worse. People risk it
because it is may help the alcoholic admit that he/she has a problem.
Admitting this is the first step in accepting help. In Step 8, I explain what
an intervention is. I guide you through the nuts and bolts of the
process. More often than not, a professional should be involved to
organize and oversee the process.

PROCEED TO STEP 8









Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
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Copyright ! 2009 Sarita Uhr, M.D.
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$'!
Step 8 : Learn how to stage an intervention

The Final Rescue Attempt to Get the Addict to Accept Treatment

Q: What is an intervention?
A: An intervention is when family and friends get together as a group and
confront the addict with the consequences of his/her addiction. Each one
states the impact of the alcoholics disease on his/her life. Often, a trained
professional, known as an interventionist, is included.

Five Steps for Staging an Intervention

Step One- Hire a professional interventionist

A professional interventionist can guide you through the complex
process of a successful intervention (rehabilitation programs can
recommend interventionists as well as therapists that specialize in
addiction or you can do an internet search for alcohol interventions for
information). The role of the interventionist is to keep the process
positive and non-judgmental. The interventionist teaches you to
approach the addicted family member in a caring way. Angry emotions and
resentment have built up as a consequence of the addicts irresponsible
behavior and these feelings must not dominate the process.



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Step 8 : Learn how to stage an intervention
The Final Rescue Attempt to Get the Addict to Accept Treatment

Step Two- Carefully plan the intervention

Decide who is going to be included in the intervention (the more people the
better), where it will take place and when it will take place. It takes 2-3
weeks to plan an intervention. Family members, close friends, or even
bosses may be included. Each person writes a letter stating the positive
contributions of the addicted family member (or employee) before they
started abusing alcohol. For example, You used to come to all my
soccer games or We loved when we ate dinner as a family. The second
part of the letter addresses the consequences of how his/her drinking
has impacted you. Specific examples of his/her behavior are given.

Make arrangements for a treatment program prior to the intervention.
Make arrangements for admission to a program to take place on the day of
the intervention. Work out health insurance and financial arrangements in
advance. Decide who will escort the person to the program (in many cases,
the interventionist will do this). Get appropriate plane tickets, if necessary.
Pack his/her suitcase.

Have a back up plan. If the intervention fails, make legal arrangements, if
necessary, for the safety of the children.




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Copyright ! 2009 Sarita Uhr, M.D.
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Step 8 : Learn how to stage an intervention
The Final Rescue Attempt to Get the Addict to Accept Treatment

Step Three- Practice the Intervention Without The Person
Present

Organize the intervention in advance. Practice reading the letters out
loud the day before the intervention. Angry or judgmental letters should be
rewritten. Determine the order of who reads the letters. Anticipate
different outcomes. For example, what happens if the person gets angry
and walks out of the intervention? Who should try and bring him/her back
in the room? Who has the most positive influence? Is there any physical
danger? For example, are there weapons in the house? (Remove them).

Step Four- The Intervention
The interventionist introduces him/herself and explains to the addicted
family member why the intervention is taking place and asks him/her to
sit and listen to the letters. Each person takes a turn reading his/her
letters. At the end of this process, the interventionist informs him/her of
the treatment arrangements that have been made. The interventionist
directs the entire process. There are a lot of very powerful emotions that
surface during an intervention and it is the interventionists job to keep it
on a positive track.




Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
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Copyright ! 2009 Sarita Uhr, M.D.
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$*!
Step 8 : Learn how to stage an intervention
The Final Rescue Attempt to Get the Addict to Accept Treatment

Five things you should know about interventions:
An intervention is an important step in breaking down the denial of the
addict regarding his/her disease.
It may save his/her life.
Sometimes the process can fail and can cause even more harm than
good to family relationships.
Interventions are a very emotional process.
Interventions can help family members identify the role he/she has played
in enabling the addiction. A good recovery program helps the family,
not just the addict. I cant overstate this. In addition to the
intervention, family members can get a lot of help by participating in
Families Anonymous (FA) meetings. There are several locations in
different cities and the meetings are free. The program is excellent
because the focus is the family unit. Al-Anon is a very important support
group for family members of addicts. There are multiple locations in every
city and there is no charge to attend the meetings. Both groups have on
line options to participate as well.







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What does treatment for alcoholism involve?
Alcoholism cannot be cured. Often the recovery process involves
times of sobriety as well as relapses. There is no magic form of therapy
or magic pill that guarantees sobriety. A multi-factorial approach has
the best chance of success. For example, the combination of different
disciplines such as the use of medications, psychotherapy, group
therapy, family therapy, 12 step programs such as Alcoholics
Anonymous, relaxation training, yoga etc. enhances the chance of a
successful recovery.
Step 9 educates you about all aspects of alcohol treatment. I outline
different treatment options. For example, some alcoholics go to a
rehabilitation facility for treatment whereas others participate in an
intensive outpatient program. Others choose to participate in AA regularly
and may supplement this with weekly therapy. These decisions are
influenced by how severe the alcohol problem is, finances, legal
consequences, and the preferences of the person suffering from
alcoholism and his/her family. In step 9, I explain the different types of
medications used for both withdrawal symptoms and maintenance
therapy as well as outline in a clear way the different forms of
psychotherapy that are available.

PROCEED to STEP 9








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Step 9: Learn about potential treatments
Options for Treatment

What does the treatment of alcoholism involve?

There are often four components to treatment:
1. Detoxification
2. A Rehabilitation program.
3. An Aftercare program
4. A 12-step program such as Alcoholics Anonymous (AA and Al-Anon).

Detoxification
The goal is to prevent symptoms of alcohol withdrawal.
May be done in the hospital over 4-7 days or on an outpatient basis.
Typical medications used to prevent and/or reverse symptoms of alcohol
withdrawal are Ativan, Valium, Librium, Neurontin. or Baclofen.
The patient is given thiamine and folic acid (both B vitamins) to correct the
nutritional deficiencies common in alcoholism. (Thiamine deficiency can
lead to Wernickes Encepholopathy. This is a neurological disorder
involving problems with eye movement, balance, and memory. Folic acid
deficiency can lead to anemia).
The patient is hydrated with IV fluids.
Physical problems such as any heart, liver problems, or high blood
pressure may be addressed and if present may lead to a longer hospital
stay until the patient is medically stable.


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Step 9: Learn about potential treatments
Options for Treatment

Rehabilitation Program
May be an inpatient program or an intensive outpatient program.
Inpatient programs typically last 30-90 days. In some cases, the patient
goes to a residential aftercare program to increase their chance of
remaining sober.
Intensive outpatient programs typically meet for 3 hours, 3-4 days a
week, often in the evening. These programs are geared toward people
who cant miss work. They often last about 12 weeks.

Components of a Rehabilitation Program
Education about alcoholism
Counseling (individual, group therapy, and family counseling)
Psychiatric evaluation and possibly pharmacotherapy
Stress Reduction
12-Step Participation
Structured Activities






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Step 9: Learn about potential treatments
Options for Treatment

Counseling:
Individual counseling may involve forms of cognitive behavioral therapy that
help correct the distorted thinking and negative attitudes that alcoholics
experience. In therapy, the person identifies his/her triggers for drinking and
learns skills to avoid relapses. Communication skills are worked on. Techniques
to reduce stress are learned. Anger management is often addressed.
Group Therapy is helpful for getting through an addicts denial. The addicts
peers are likely to confront an addicts excuses for his/ her behavior. Group
sessions help the addict learn to deal with confrontation in a positive way.
Family Counseling is crucial. It focuses on education about the disease as well
as the roles different family members play in enabling the disease. Often an
addict has as easier time maintaining sobriety if he/she is no longer enabled.
Psychiatric Evaluation
Every person should be assessed by a psychiatrist and should be evaluated for
alcohol abuse versus alcohol dependence. It is important to determine what
other substances are being abused such as cocaine or marijuana. It is extremely
important to evaluate for other diagnoses such as Anxiety, Depression, or
Bipolar Disorder. Different diagnoses may change the treatment options.




Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
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Step 9: Learn about potential treatments
Options for Treatment

Pharmacotherapy Options May include:
Anti craving drugs:
Campral - reduces the craving for alcohol by affecting a neurotransmitter called
glutamate. It restores the balance of glutamate in the brain.
Revia reduces craving for alcohol by blocking the high from opiates and
alcohol. It may speed up the healing process of the damaged brain from
repeated alcohol exposure.
Vivitrol -is an injectable form of Revia and lasts 30 days.
Topamax- is an anticonvulsant that has been shown to reduce alcohol cravings.
Deterrent Drug:
Antabuse (Disulfiram) - causes severe nausea, flushing, and headache if
someone drinks with it. It deters an addict from relapsing because the
experience is horrendous.
Antidepressants and anti-anxiety drugs- treat the depression and
anxiety that often accompanies alcoholism. Examples are Lexapro, Zoloft,
Pristiq, Paxil.
Mood Stabilizers are effective if Bipolar Disorder is present. Examples are
Depakoate, Seroquel, Lithium, Limictal


Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
%&!
Step 9: Learn about potential treatments
Options for Treatment

Stress Reduction may include:
Biofeedback
Yoga
Exercise
Relaxation techniques
Life style change
Improved communication skills
A strong support system

12 Step Program
The 12-step program for alcoholics is called Alcoholics Anonymous (AA).
It is a support group comprised of alcoholics at all different stages of
sobriety.
The goal is total abstinence from alcohol.
People share their experiences and encourage and support one another.
AA meetings are free to attend. The organization is supported by member
donations.
There are multiple locations available as well as different meeting times.
It is not affiliated with any organization or religious group.
It is spiritually based in that one is supposed to recognize the existence of
a greater power to surrender oneself to (this puts some people off).


Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
%'!
Step 9: Learn about potential treatments
Options for Treatment

12-Step Program
Early on in sobriety, a person may choose to attend AA every day. Others
go less frequently, but it is recommended that a person at the early
stages of his/her sobriety attend as frequently as possible.
In my experience, as a psychiatrist, the people who attend AA on a regular
basis have the best chance of remaining sober. It is no guarantee, but it
helps people stay committed to his/her goal.
A person who goes to AA is encouraged to get a sponsor who has some
success with sobriety.
The sponsor is a mentor that can help support the person as well as
guide them through the 12 steps.
Without listing the individual steps, the highlights include admitting you are
powerless over your addiction, taking an inventory of your actions while
you were drinking, listing the people that have been impacted by your
disease, and making amends to the people you have hurt.
AA does not provide therapists. It does not take the place of therapy.
It is a very important part of most alcohol treatment programs.
Family members are encouraged to attend Al-Anon, the organization that
is the 12-step program for the spouses, friends, and adult children of an
alcoholic or they may attend Families Anonymous. Alateen is part of Al-
Anon and is the 12-step program for teenagers whose family member is
an alcoholic. The goal of these programs is to support one another in
solving the problems of codependency and enabling as well as other
problems they share.

Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
%(!

Step 9: Learn about potential treatments
Options for Treatment

Structured Activities
Inpatient programs often offer fun enrichment activities such as going to the
movies, sports activities etc. These activities are supervised so the patient has
less chance of relapsing during their recovery program.

Residential Aftercare
Many recovery programs offer residential aftercare programs. These
programs represent a transition phase before the person is ready for
discharge.
The program provides a room in a house or an apartment that the person
shares with another recovering alcoholic.
There is less supervision (more freedom) than the first phase of the
recovery program.
The person is expected to become involved with the community. This
usually means starting a job and showing more responsibility.
The person continues to participate in therapy and AA.
This transition phase tests the skills learned in the first phase of treatment.
If there is a relapse, certain freedoms are lost. As responsible behavior is
demonstrated over time, certain privileges can be regained.
Studies show that longer programs tend to increase the chance of
sobriety.


Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
%)!

How Do Help Your Recovering Spouse
When a person is in recovery, the dynamics of the family completely
change. It can actually be a very difficult time. In the marriage, typical
problems that occur are feelings that you are no longer needed. Your
partner is taking more responsibility for him/herself. You may even feel
jealous and resentful with the 12-step program that takes him/her away
from you and the family for hours at a time. It can feel very threatening
and lonely when he/she starts out on this new path.
You will have to learn to take care of yourself for the first time. Your
spouse, too, is learning to take care of him/herself in healthier ways. This
transition takes time and patience. Also, relapses are common and
can bring up a lot of old feelings of resentment and fear. Step 10
provides the roadmap of steps to take to be supportive of the
recovery process.

PROCEED TO STEP 10





Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
%*!
Step 10: Help Your Spouse in Their Recovery
Speak up at the time something is bothering you.
Dont expect consistent progress. Relapses are common. Over time,
longer periods of sobriety may occur.
Encourage your spouse to attend AA meetings. He/she needs this
support even though it takes time away from the family.
Dont feel guilty that sometimes you resent coming in second to
sobriety. Many people in your position share this sentiment.
Get support! Go to Al-Anon, talk to friends and relatives, Talk to a
therapist that specializes in addiction and understands what you are
going through.
Encourage your spouse to develop his/her own support system.
Dont micromanage your spouses sobriety.
Encourage your spouse to be responsible for his/herself.
Dont lie or cover up for your spouse if he/she relapses.
Acknowledge his/her improvement and encourage attaining new goals.
Take care of your physical health by getting a good nights sleep and
eating nutritious meals. Encourage your spouse to follow suit.
Learn to listen to each other and show compassion and support.
Be respectful with each other in your words and your actions.
Spend time together as a couple and get reconnected.
Recognize it takes time for both of you to adjust. Dont expect
overnight improvement when he/she gets sober. You are learning to be
wanted, not just needed. A lot of negative feelings have built up and
damaged the relationship. Over time, these feelings may diminish as
trust is rebuilt. Some couples cant overcome these angry feelings and
choose to get divorced.
Aim for a new healthier relationship and lifestyle mentally, physically,
and emotionally.

Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
&+!
Main Obstacles to Treatment

The alcoholic is still in denial and refuses treatment.
There may be drug abuse in addition to alcohol abuse (cocaine abuse,
pain pill abuse, Xanax abuse, or amphetamine abuse). This may make
the treatment more complicated.
There may be another mental health disorder on top of the Alcohol
Dependence such as Bipolar Disorder, a Depressive Disorder, an Anxiety
Disorder, or Narcissism that must be addressed as well. This is a very
common scenario (this is called dual diagnosis which means more than
one diagnosis) is present.
Both spouses may be alcoholic and one spouse does not support the
other spouse getting treatment.
There may not be the finances available to pay for treatment. (Remember
Alcoholics Anonymous is free). *

Obstacles to Treatment
Denial
Accompanying drug abuse
Another mental health disorder
Both spouses alcoholic
Lack of finances




Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
&"!
Summary of the Key Points

Alcoholism is a chronic and progressive disease.
Alcoholics drink because their brains are addicted to alcohol, not because
they have a weak character or lack willpower.
Alcoholism is a treatable disease.
The longer one maintains sobriety, the greater the chance sobriety will
continue.
It is a family disease. Family members perpetuate the illness by not
allowing the alcoholic to experience the consequences of his/her
disease.
A person who abuses alcohol gets better only when his/her family
members quit enabling him/her.
The new medications for treating alcoholism are very beneficial in both
reducing cravings and speeding up the healing of some of the brain
damage caused by excessive drinking.
From a psychiatrists perspective, treating anxiety, depression, or other
mental health disorders with the appropriate medications increases the
chance of sobriety.
Rehabilitation programs with their multifaceted approaches to therapy as
well as encouraging life style changes are often a necessary step in
starting an alcoholic on a recovery path.
12-step programs such as AA are often crucial to maintaining sobriety.
12-step programs such as Al-Anon are often crucial to the family members
of an alcoholic to overcome their codependency issues as well as get
support.
Therapy is key for dealing with the distorted thinking of an alcoholic,
working on his/her childhood issues, and dealing with the psychological
fall out from his/her disease on his/herself and the people he/she loves.

Stop Being a Victim! A 10 Step Guide to Rescuing Your Marriage to
an Alcoholic


Copyright ! 2009 Sarita Uhr, M.D.
!
&#!
Encouragement Tidbits

Learn to affirm yourself every day
Put 100 good thoughts in your head.
Start with thinking one positive thought, then two, then threethen
10, 20100.
Think about it.
You take your thoughts everywhere you go.
The more positive your thinking, the more positive your mood.
Think positive.
This affirms you.
And you affirm your life!










Bibliography and Resources
Websites
Alcoholics Anonymous- http://www.aa.org/ Al-Anon- http://
www.al-anon.alateen.org,
Families Anonymous - http:www.familiesanonymous.oig
Betty Foiu Chiluien's Piogiam- http:
www.bettyfoiucentei.oigchiluien
CAuE questionnaiie (scieening tool foi alcoholism)- http:
www.meick.healthinkonline.commeickTools
AssessNeickSouiceCAuE.asp
CDC Center for Disease Control and Prevention
(Department of Health and Human Services)- http://
www.cdc.gov ( Facts on Fetal alcohol syndrome)
Co-dependents Anonymous- http://www.codependents.org/
index.php
BealthatBealth.com- http:www.athealth.comconsumei
uisoiueisalcoholfamily.html
Nayo Clinic -http:www.mayoclinic.comhealthalcoholism
BSuuS4uBSECTI0N=tieatments-anu-uiugs (This piogiam is
baseu on a meuical mouel, not a 12 step piogiam).
Mental Health America- http://www.nmha.org/go/
codependency
National Institute of Alcohol Abuse and Alcoholism (NIAAA)-
http://www.niaaa.nih.gov
Substance Abuse/ Mental Health Services Administration-
http://www.samhsa.gov/
http:ncaui.samhsa.gov
National Alcohol Substance Abuse Infoimation (Inteiventions)
http:www.auuictioncaieoptions.com
Stop Being a Victim! A 10 Step Guide to Rescuing Your
Marriage to an Alcoholic
Copyright 2009 Sarita Uhr, M.D. 53
Bibliography and Resources
!""#$
American Psychiatric Association, Diagnostic and Statistical
Manual of Mental Disorders, 4th ed, revised (DSM-IV-TR).
Washington, DC, 2000.
Conyers, B: Addict in the Family: Stories of Hope and
Recovery, Hazelden, 2003.
Herrick, C, Herrick Ch: 100 Questions and Answers about
Alcoholism, Jones and Bartlett Publishers, 2007.
Kellogg, T: Broken Toys, Broken Dreams: Understanding and
Healing Codependency, Compulsive Behaviors, and Family,
BRAT Publishing Corporation, 1990.
Stahl, Stephen M. Essential Psychopharmacology:
Neuroscientic Basis and Practical Applications, 2
nd
Edition,
Cambridge University Press, 2006.
Urshel lll, H: Healing the Addicted Brain: The Revolutionary,
Science-Based Alcoholism and Addiction Recovery
Program, 1
st
Edition, Illinois, Sourcebooks Inc., 2009.
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Stop Being a Victim! A 10 Step Guide to Rescuing Your
Marriage to an Alcoholic
Copyright 2009 Sarita Uhr, M.D. 54