Awareness and understanding of your own situation, behavior and needs is the first step towards change.
In the fourth quarter of 1999, a basic program of co-addiction therapy (PPTW) financed by PARPA was implemented in 26 rehab centers. Group classes were held once a week for 3 hours. In parallel, patients in most facilities participated in bi-weekly individual meetings.
Therapeutic work was carried out in accordance with the program developed by Mirosława Kisiel (Kisiel, 1997). It covered the following issues.
knowledge of alcoholism, who is an alcoholic, symptoms and stages of alcoholism, an illusion and denial system, treatment of alcoholism;
influence of alcoholism on the family;
co-dependence in an alcoholic family overresponsibility and control, not directing one’s life, powerlessness towards a loved one’s alcoholism;
psychological effects of codependence (adaptation to a destructive relationship).
Simultaneously with therapeutic interactions, a research project was carried out to capture changes in the functioning of co-dependent women under the influence of the basic therapy program. His results were particularly intriguing for several reasons, but mainly because we proceeded to conduct the first analysis of this type.
In the study, we used a set of tools used in the APETOW program. The first measurement was carried out in the initial therapy phase. The second measurement was taken when the patient finished the therapeutic program or when she interrupted contact with the facility.
The goal of the basic stage of therapy was to help the co-addicted person recognize the situation in which he or she finds himself and understand his / her patterns of behavior in relation to an alcoholic (Mellibruda, Sobolewska, 1997). Therefore, changes in the functioning of co-addicted women under the influence of therapy should primarily concern the behavioral and cognitive sphere. In the meantime, it turned out that the results of the basic therapy program for co-addicts apply to all areas studied by us, and thus also to the emotional sphere and general mental state.
The study group consisted of 166 co-addicted women aged 21 to 66 years. The average age was 41 years. The vast majority of them were married (80%) and lived with their husband, and 95% of the whole group had at least one child.
It was a well-educated group 69% of respondents had at least secondary education; with a relatively good professional situation, every fifth respondent did not have any employment or worked part-time. Other people had a permanent source of gait, so they were financially independent of the partner.
Most women surveyed lived in a large city (30%). It is worth noting the difference here from those participating in the APETOW program, where almost 80% of them lived in a city of over 100,000. residents. This means that the therapeutic offer was not only given to women from smaller urban centers, but also to people from the countryside (18%).
As expected, the study of codependence-related behaviors showed the positive effects of a basic codependence therapy program, participation in it taught co-addicted women more constructive behaviors. Psychoeducation certainly provided knowledge about the role played by the addict’s partner in the development of alcoholism. However, it cannot be determined whether the answers obtained in the second measurement reflect the actual change in behavior or are only the result of psychoeducation. Next, we will show specific examples of how patients modified their behavior after therapy.
When the husband came back drunk and fell asleep on the floor, before therapy most women claimed to leave him alone. After treatment, however, this percentage increased significantly (38% and 57%, respectively). It is worth noting that at the same time the percentage of women who took care of a drunken husband or took his money decreased.
The therapy also brought results in terms of changing the tendency to control her husband’s drinking. Co-addicted alcohol found before the therapy usually poured into the sink or hid from her husband.
Under the influence of therapy, not all women gave up on restricting their husband’s access to alcohol, but more than half of the respondents (51%) leave the bottle after the therapy where they found it.
The wife’s response to her husband’s strings both before and after therapy is generally isolation from him (50% and 58%, respectively). On the other hand, the percentage of women who continued to try their best to meet their household responsibilities in order not to give their partner reason for fist or quarrel (from 21% to 6%), while at the same time the percentage increased from 4% to 21% people who then call for a ride to take the drunk to the sobering-up center.
It seems that for the co-addicted respondents, drinking a husband is as difficult as sobriety. It is true that the number of women who do not behave in such circumstances in any particular way has increased, as well as those who at the time take advantage of the opportunity and urge her husband to take treatment. However, it should also be noted that every sixth co-addicted (every fourth before therapy) lives in suspense, awaiting the moment when the husband drinks.
After the end of therapy, co-addicts give up a higher degree of responsibility for the consequences of drinking their husband. Most of them (65%), when the husband is unable to go to work due to alcohol-indisposition, does not pay attention to his needs and takes care of his own affairs. Only one out of the person completing the therapy was still trying to get her husband to his feet, while nearly 13% of women did so before the therapy.
The therapy also had a positive effect on leaving social isolation. Although the percentage of women resigning from social life due to getting drunk on their husband remained relatively high, it is worth noting here a large drop of 15%. At the same time, more people decided to go to social gatherings without a husband (16% starting this rap and 43% finishing).
Participation in therapeutic classes made it easier for co-addicted women to seek help outside in situations of violence. More than half of them decided to notify the police before police intervention was used by every fourth co-addicted respondent. At the same time, the percentage of people passively enduring their husband’s beating decreased (from 13% to 2%).
Although the basic therapy program is not aimed at discovering and changing beliefs about marriage, the family, the relationship between a woman and a man, the way of seeing each other, etc., therapeutic work at this level has also brought positive results. This suggests that providing information on alcoholism and co-addiction in at least some people begins the process of changing themselves, including negative life scripts.
The analysis of individual statements showed a change in almost all beliefs, especially those whose modification seems very important from the point of view of getting out of codependence.
A particularly important change concerns the group of views related to the social isolation of the family and hindering seeking outside help. The results of the measurement carried out at the beginning of therapy indicated this type of beliefs as the main mechanism contributing to the development of codependence in this group of women. As a result of participating in the therapeutic program, respondents are less inclined to say that “you shouldn’t say bad things about your own family” or “no outsider can help unless your husband and wife get along.” This means that the therapeutic interventions used have helped patients verify the most dangerous cognitive patterns.
On the other hand, the lack of results seems to be worrying when it comes to maintaining the hope that the husband will come to his senses and stop drinking. 54% of the co-addicts agree (rather and definitely) with this statement. Such an approach can be considered justified and advisable in the event that the partners of the examined women attempt to quit the addiction. This situation affects about half of the co-addicts. However, in the group of women hoping that their husband will stop drinking, only slightly more than half of them (57%) actually have a husband who has not abused alcohol in the last month. Therefore, these results raise some doubts as to the rationality of the hope of the wives of alcoholics.
Probably, psychoeducation, by providing knowledge about alcoholism and co-addiction, is able to convince his wife of the lack of her responsibility for drinking her husband, the need to take care of herself, etc. She leaves the door open for magical and lending thinking.
From the point of view of cognitive concepts, emotional response is secondary to cognition. Man, giving meaning to a given situation, creates such and no other emotional state. So the modification of thinking determines the emotional change. Based on such premises, we expected that the basic therapeutic program, by providing information on the mechanisms of addiction and co-addiction, would allow patients to have a different view on their family situation and thus a different emotional response. And indeed the results showed a significant positive change in emotional balance.