Relationships with an alcoholic

SAMHSA’s National Helpline | SAMHSA

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  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

  • Suggested Resources

    What Is Substance Abuse Treatment? A Booklet for Families
    Created for family members of people with alcohol abuse or drug abuse problems. Answers questions about substance abuse, its symptoms, different types of treatment, and recovery. Addresses concerns of children of parents with substance use/abuse problems.

    It's Not Your Fault (NACoA) (PDF | 12 KB)
    Assures teens with parents who abuse alcohol or drugs that, "It's not your fault!" and that they are not alone. Encourages teens to seek emotional support from other adults, school counselors, and youth support groups such as Alateen, and provides a resource list.

    After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
    Aids family members in coping with the aftermath of a relative's suicide attempt. Describes the emergency department treatment process, lists questions to ask about follow-up treatment, and describes how to reduce risk and ensure safety at home.

    Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction
    Explores the role of family therapy in recovery from mental illness or substance abuse. Explains how family therapy sessions are run and who conducts them, describes a typical session, and provides information on its effectiveness in recovery.

    For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

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The Locator is authorized by the 21st Century Cures Act (Public Law 114-255, Section 9006; 42 U.S.C. 290bb-36d). SAMHSA endeavors to keep the Locator current. All information in the Locator is updated annually from facility responses to SAMHSA’s National Substance Use and Mental Health Services Survey (N-SUMHSS). New facilities that have completed an abbreviated survey and met all the qualifications are added monthly. Updates to facility names, addresses, telephone numbers, and services are made weekly for facilities informing SAMHSA of changes. Facilities may request additions or changes to their information by sending an e-mail to [email protected], by calling the BHSIS Project Office at 1-833-888-1553 (Mon-Fri 8-6 ET), or by electronic form submission using the Locator online application form (intended for additions of new facilities).

90,000 Marriages with alcoholics are the strongest. Psychologist on codependency and healthy relationships

Many families have dependent relatives, alcoholics or drug addicts. Their spouses endure this all their lives and do not leave. Some call it love, but experts know it's codependency.

Psychologist Anastasia Kim told Omsk Here what to do if your family has a codependent relative and what factors can affect the development of this pathological condition in a person.

- What is codependency? How widespread is this phenomenon in our country and in the world as a whole?

- Let's look at the word itself - codependency. It has a prefix - co-, which means "attachment". If we take the word literally, then it will be interpreted as "attached dependency". In general, codependence is a pathological desire for another person who has an addiction: alcoholism, drug addiction, gambling, etc. Based on my work experience, I can say that codependence is the progenitor of all addictions.

If you answer the question, with what appeals do you most often come to a psychologist, then about 95% are addiction and codependence. This is due, among other things, to the situation in the country. There are many people in Russia who suffer from alcoholism and drug addiction.

I also want to note such an interesting point that workaholism is a socially acceptable form of addiction. But at the same time, children who are brought up in families of workaholics suffer from an attention deficit no less than children who are brought up in families of alcoholics and drug addicts.

If we talk about other countries, then in the USA, for example, much attention is paid to codependency. There are groups in which people work on themselves and get rid of this disease, this is very common. I can say with confidence that codependency is progressing in those countries where dysfunctional families are common. If people have to survive, then children in such situations fade into the background, the number of divorces increases, and the level of codependency, of course, increases. I can safely assume that in those countries where there is a clear family structure and the distribution of roles between men and women, this phenomenon is less common. We are talking about Eastern countries.

If we talk about our country and why codependency flourishes in our country, modern culture and media make a big contribution here. Take movies, songs, music videos - many of them promote illegal substances, alcohol, unhealthy relationships. There are few places in culture where works about healthy love are found, mostly toxic, unhealthy relationships are cultivated. This is all deposited in the subconscious of children, and over time it seems that this is the norm, that love and pain are closely related, although this is absolutely not the case.

- How is codependency formed? What are the risk factors for its development?

- Codependency is formed from birth, and if nothing is done about it, it progresses throughout life. If we talk about factors, then the first is a genetic predisposition. If once in your family there were people with addictions along the line of mom or dad, then the risk that one of the offspring will also have addiction or codependency increases. The second factor is single-parent families and families with relatives who suffer from addiction. The third is low self-esteem. The fourth factor is indifference to the upbringing of the child. This happens for various reasons, but the main one is that people get tired at work, they worry that they may be left without income, and in this case there is practically no time left to raise their own children.

I would like to note the historical "component" that exists in our country: during the war years, men were at the front, and women carried all the burden of everyday worries, and this "gene of strong women" lives in us, and when it will degenerate, it is difficult to say.

And, of course, the formation of codependency is influenced by the fact that people often marry emotionally immature. A person must be able to take care of himself in order to be ready to take responsibility for others. It is worth noting that women are more prone to codependency.

- Why women? Does it happen that men fall into codependency?

- If we take men and women as 100%, then, as a rule, women suffer from codependence in 97% of cases. In men, this phenomenon happens, but it is extremely rare. In practice, there are cases when husbands, fathers, brothers send their relatives for rehabilitation, go to groups for co-dependents. It is connected, first of all, with male psychology. Men are less emotional, rational. Since the dependence is emotional, it is more difficult for them to fall into codependency. They say in society that men don’t cry, so many of them are afraid to express their feelings, they don’t show what’s on their minds, and they go into addictions - use alcohol, illegal substances, start gambling or they develop sexaholism.

- How to independently understand that you are a co-dependent? What are the stages of codependency?

- Doing it yourself is hard, almost impossible. Usually, understanding begins to come when a person is faced with some painful circumstances: he begins to lose his health, he begins to experience depression, panic attacks, suicide attempts and enormous problems with a partner.

One of the sure signs is when your loved ones, family and friends start saying, "What are you doing? You're in the wrong relationship, think about yourself." This is a very important call. But most girls, after watching movies and TV shows, think like this: "Me and him, we are against the whole world, we can handle it, I will help him, with my love I will create a miracle." But everything continues all over again.

There are three main stages of codependence. Early - partners are just starting to get to know each other, and everyone is trying to put themselves in the best light. It is much easier to immediately show who you are, and not to "stand on tiptoe", because it is very difficult to do this for a long time. In the end, a person will still have to reveal himself. At the first stage, a girl should listen to herself and her feelings: in addition to euphoria and love for a partner, a feeling of pity may arise. This is the first step - the desire to help, save. But one must distinguish between pity and sympathy. The last thing is when you and your partner are on an equal footing, you sympathize with him, you say that he will cope with everything and sometimes unpleasant things happen, but there is no desire to compensate for this situation. And with pity, the partner becomes, as it were, lower than you, and you no longer show him partner, but motherly love.

Gradually, a codependent person gives up his interests, because he needs to constantly help his partner. That is, the girl communicates less often with her friends, stops going to the gym, to some courses, forgets about everything she used to do, and shifts all focus to her partner. The mood is often synchronized - if it is spoiled in a man, then the woman will be sad.

What happens next? At the middle stage , the codependent partner begins to deny. This mechanism is characteristic of any addiction and codependency as well. The problem is downplayed. The partner can steal the money, and the codependent starts saying, "Well, the amount isn't that big, he'll pay it back."

The girl begins to rationalize everything, to explain to herself the motives of her partner's behavior. There may be a situation when a guy gets into a fight at some holiday, and the girl tries to justify him for herself: "He mixed alcohol and drugs, so this situation turned out." And that doesn't scare her at all. This is how denial works.

Another girl can start comparing her relationships with strangers and thinks: "Here, a friend's husband uses drugs every day, and mine only on weekends, there is nothing supernatural in this." The following phenomenon arises: maintaining the facade of a "happy couple". The girl, being in a co-dependent relationship, wants to show with her whole appearance that everything is fine in their family, and, as a result, she begins to hide some facts of her partner’s negative behavior. An important signal: the emergence of feelings of guilt. It begins to seem that a man uses, behaves this way because of my behavior. The co-dependent begins to build a relationship: "If I had been more patient, he would have behaved differently. If I had prepared the meal on time, the partner would have been more accommodating."

At the third stage , a codependent person develops a depressive state, panic attacks. The whole life of the co-dependent begins to revolve around the addict, because he needs to be helped and controlled.

- Often relatives do not understand why their girlfriend/acquaintance/sister lives with an addict, and does not leave him or save herself. How does the psyche of a codependent person begin to work? Why can't a person realize what he is doing wrong? What mechanisms are involved?

- A codependent person has a predisposition to this. In the soul of a codependent person, there is initially a void that needs to be filled. And he, like a hungry person who eats everything indiscriminately, just to get enough, begins to communicate and easily enters into difficult, toxic relationships. And then the following happens. I will give as an example my favorite parable about a frog: if you throw it into boiling water, it will jump out, and if you gradually heat the water, the frog will not notice the temperature increase and will boil in boiling water. The same thing happens with a codependent person: gradually tolerance grows. In co-dependent relationships, there is obsession: the co-dependent sees only his partner.

- Can this be considered a mental disorder?

- According to the international classifier of diseases, codependency is classified as a mental disorder, but for this you need to contact a psychiatrist so that he can accurately diagnose and prescribe therapy. But codependents usually do not go anywhere. They are not aware of the actions they are doing.

- What should you do if you see that your loved one is in a co-dependent relationship? Can he get out of them on his own?

- If a person has started therapy, he can be cured. It is almost impossible to pull yourself out of co-dependent relationships and such a state on your own. Relatives may try to talk to the co-addict, it is important not to put pressure on the person and try to carefully provide information about code-dependence: throw a link to an article, to a site about code-dependence, recommend the help of a psychologist or work in groups. Awareness of the disease does not come to everyone. Women who live in families with alcoholics often do not listen to the recommendations of specialists, doctors and continue, most likely, unconsciously to stay in these relationships. They don't take in information. No wonder they say that marriages with alcoholics are the strongest.

- What is the difference between healthy and codependent relationships?

- It is quite logical that both partners must be healthy to build them. In a healthy relationship, a constructive conversation can be built, while in a codependent relationship, exclusively manipulative communication prevails. In healthy relationships, there is joy, love, respect, trust, understanding, in toxic relationships - pain, fear, resentment, guilt, and so on. In co-dependent relationships, partners are not equal, such a vertical is built: someone is a victim, someone is a rescuer, and in adequate relationships, partners push each other to development.

A couple in a toxic relationship has three outcomes: either they break up, or they stay at the same level of development, or they both recover. It can take about three years to get rid of codependency.

- If a person left such a relationship, is there a risk of getting into it again? What should not be allowed in order not to slide into codependency?

- There is a risk, and a very big one. Paradox: a woman who has been in a difficult relationship should not make mistakes.

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