Over fifteen years ago in my private practice in South Florida I was again working with a couple that seemed “stuck.” My therapeutic skills were meeting a relationship standoff. I was starting to think that I had been sucked into their system and therefore unable to make a difference.
In session three the husband and wife were again relying on an all too familiar scenario. One month prior to coming to my office the wife, then 48, had again drank herself into a blackout followed by a pass out on the floor while the husband made dinner for their four school aged children, watched over their homework, and orchestrated the home chores. She went to a rehabilitation center for 30 days. Newly sober, she was still very mentally fuzzy and told her husband how sorry she was. But it was as if every time she said she was sorry (which was often) he just became angrier and would sometimes walk out of session. Their story is as follows.
They had married young while in college. They immediately became pregnant and the wife dropped out of school. They had the baby and within 3 months they were pregnant again. The husband remained in school and worked a full time job in a local shoe store. He would come home exhausted only to work on homework and the wife, who was overwhelmed and isolated and equally exhausted, would kiss him on the forehead and fall asleep. When the husband graduated college with his business degree two years later the grandparents took the two kids and gave them a week vacation. They slept most of it and came back pregnant with twins.
With four children not yet in school, the wife worked at home as a full time mother and housekeeper and the husband worked two entry level jobs. Her dream of being an artist had been shattered by a life that she felt they chose but also believed in her heart she had little decision in constructing. She looked for solutions to what she described as symptoms of postpartum depression. The wife started lightly drinking during nap times when the house was quiet. The drinking seemed to work and she found herself able to clean the house and make dinner without the crushing crying jags that had her crumble to the floor. If a little drinking was good, she surmised, maybe more drinking would be better. Fast forward a couple of years and she was passing out during the day while the four children watched videos and ate finger food she would set out before her daily drinking. After a while she could no longer get it together enough to clean everything up and make dinner. Her husband started walking in to chaos at the end of his work day. Through the next few years the wife tried to stop drinking, sometimes by herself, and sometimes with AA. Through it all her main communication with her husband was “I’m sorry.”
The family isolated. The children were in school during the day and would come home and cook and clean to help protect their mother. The husband was finally able to work from home, and his life turned into caring for the children and his wife, paying the bills, keeping the house together, working and attending Al-Anon meetings whenever he could. And one day, while the husband had a doctor’s appointment, the stove was left on and the kids came home from school and found the kitchen on fire while mom was passed out on the living room floor. A family intervention took place. The wife was finally brought to an alcohol and drug rehabilitation center by her husband and sister where she was introduced to her life as it was now. To her horror she realized she remembered very little of important milestones she seemed to participate in during the last ten years of her life. The wife continued to tell her husband, children, mother and sister that she was again sorry.
Session three was going nowhere. The husband had stormed out of the office after another “I’m sorry” from the wife. He was outside smoking a cigarette. The plan was to have a full family meeting on the fourth session but at this rate I knew it was not going to happen. I had to use my skills and think of a different approach to what was before me. The wife had her head in her hands. I asked her what she would have done if he had left the marriage those many years ago. She looked at me with fear in her eyes and seemed unable to answer. She then quietly said: “I would have died.”
And there it was: my intervention.
When her husband came back in I told them to face each other. He was so angry I thought he might hit her. Not only had he been the caregiver of all their lives for the past several years, the dream that he had waited for – a sober wife – was before him. All she could do was apologize and the family was now revolving around her sobriety rather than her substance dependence.
I spoke of how she had told me that she would have died without all he did over the years. He was not softening; he knew that fact. I then went out on a therapeutic limb and told her that he was sick and tired of the apologies. For so long they had sounded empty and he had lost faith in the meaning of those words.
She looked at me as if I was stripping her of her only language. I then suggested that she thank him. I think at that moment she needed some lifeline. She tenderly took his hand that was balled up tightly, stroked the top, lifted his chin to look into his eyes and said “Thank you.” “Thank you for keeping me alive.” “Thank you for growing the kids.” “Thank you for not leaving.” It was the first time that she did not seem wracked with shame; rather, she seemed to have gained some integrity and it was the first time the husband cried.
The narrative changed and the healing began. The family session took place and she wanted to meet with each child separately and then together as a family unit that could possibly heal. She regained some strength and her husband was able to access some of his vulnerability.
It seems simple. Thank you seems to be the most appropriate phrase at times, but so out of reach. There is also a possibility that “thank you”” shifts the power. However in the above case, he was not looking for power. He would not abuse power. He was looking for understanding and recognition. And the wife had to pull herself out of a shame based stance and reveal that she was cognizant of the love and sacrifices that were offered her search for a solution. Her initial solution, drinking, turned against her: however this did not negate that she, and the family, were seeking solutions.
People seem unable to move toward lasting change when they are angry or shameful: however if they feel inner strength they seem open to new solutions.