What Partners Can Do About a Spouse's Drinking and What Makes It Worse
Loving someone whose drinking has escalated is its own kind of exhaustion. You are managing their drinking and your own reaction to it. You are walking a line between saying something and saying nothing. You do not know what helps and what makes things worse. This article is for you.
By Dr. Julie Rashkis, Psy.D. | Licensed Psychologist | Menopause Society Certified Practitioner | therapyformidlife.com
'I don't know what to do anymore. If I say something, we fight and nothing changes. If I say nothing, I'm watching it get worse and I feel complicit. I've tried to control it by keeping track of how much is in the bottles, not buying wine to have in the house. I've tried to ignore it. I've cried about it. I've threatened to leave and then not left. I'm exhausted and I feel completely alone in this. And, I'm starting to wonder if anything I do makes any difference at all.'
This is one of the most painful positions in a midlife marriage or partnership: being the person on the otherside of a drinking problem that the drinking person does not fully acknowledge, while managing the uncertainty of not knowing whether your responses are helping or making things worse. The research actually has answers, not perfect ones, but clinically significant ones about what partner behaviors predict better outcomes and what partner behaviors inadvertently perpetuate the cycle.
This article addresses the partner's position directly. It covers what enabling actually is and how it differs from understandable coping, what the evidence shows about effective partner approaches, the CRAFT model as an alternative to both suffering in silence and confrontational intervention, when couples therapy becomes the most appropriate route, and what partners need for themselves in the process because the person living with the problem is not simply a lever to move the drinker toward treatment. They are a person whose own wellbeing matters, independently of whatever happens with their partner.
First: You Did Not Cause This and You Cannot Control It
Before examining what partners can do, a clinical point must be made clearly and first: you did not cause your partner's drinking problem, and you cannot control it. This is not a platitude, it is clinically precise. Alcohol use disorder is a condition with biological, psychological, and social drivers that substantially predate any particular relationship. The escalation of use during midlife is driven by neurobiological vulnerability, stress hormones, hormonal transition, identity disruption, and the pharmacological properties of alcohol itself. Your behavior did not create these factors, and managing your behavior more skillfully will not eliminate them.
This matters because the partner of someone with escalating alcohol use frequently carries a burden ofself-blame, 'if I were a better partner, if I were less demanding, if our relationship were different' that is both inaccurate and clinically damaging. Self-blame produces the kind of chronic guilt that drives the exhausting, futile management behaviors that compound the problem without improving it. Setting this down is not giving up. It is the first step toward the clearer, more grounded engagement that actually has clinical leverage.
What you can do is influence the environment in which the drinking happens. You can change your responses, hold limits, communicate differently, and create conditions that make treatment more or less likely. These are not nothing and the research shows they matter. They are also not control, and they are not certainty. Holding both truths simultaneously, that your behavior matters and that you are not responsible for the outcome, is the psychological foundation of effective partner engagement.
What Enabling Actually Is and Why It Happens
Enabling is one of the most frequently used and least precisely defined concepts in the addiction field. In clinical use, enabling refers to behaviors that reduce or remove the natural consequences of alcohol use in ways that allow the drinking to continue without the full cost being experienced by the person drinking.
Enabling is not malicious. It is almost always motivated by love, by a desire to avoid conflict, by genuine concern for the drinker's wellbeing, or by the understandable self-protection of a partner who has learned that certain situations go badly.
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Enabling Behavior: Covering consequences
What It Looks Like: Calling in sick for the partner when they are hungover; making excuses to children, family, or employers for impaired or absent behavior; managing situations the drinking partner cannot manage
Why Partners Do It/What Drives It? Genuine protection of the partner and family from immediate harm; preventing consequences that feel disproportionate; avoiding the confrontation that exposing the consequences would require
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Enabling Behavior: Managing the supply
What It Looks Like: Controlling what alcohol is in the house; not buying wine to limit access; watering down bottles; hiding or disposing of alcohol
Why Partners Do It/What Drives It? Attempts to control the uncontrollable; sense that managing the environment is the only available lever. Typically ineffective because it does not change the underlying drive and often produces conflict without reducing use.
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Enabling Behavior: Drinking together
What It Looks Like: Drinking alongside the partner to normalize the pattern; using alcohol together as a connection ritual; not drawing attention to the partner's level by drinking at similar levels
Why Partners Do It/What Drives It? Preserving connection and shared ritual; avoiding the discomfort of being the sober observer; genuine enjoyment that has become intertwined with a problematic pattern
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Enabling Behavior: Avoiding the conversation
What It Looks Like: Not raising the issue after difficult prior conversations; deciding this isn't the right time; going quiet rather than risking another fight; normalizing what is not normal
Why Partners Do It/What Drives It? Protection from conflict; hopelessness after repeated conversations that changed nothing; not wanting to be the ‘nagging' partner; uncertainty about whether the concern is proportionate
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Enabling Behavior: Threatening without following through
What It Looks Like: Stating consequences that are not then enacted; leaving and returning; setting limits that are not maintained when tested
Why Partners Do It/What Drives It? Genuine ambivalence about the limits; hope that the threat alone will produce change; not being ready for the consequences of follow-through; love and fear operating simultaneously
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Enabling Behavior: Taking over responsibilities
What It Looks Like: Absorbing household and parenting responsibilities that the drinking partner has stopped managing; compensating functionally in ways that remove the structural consequences of their withdrawal
Why Partners Do It/What Drives It? The family genuinely needs these things done; children need care; the house needs to function. This is often not avoidable, but it does reduce the experiential cost of drinking for the drinker
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Understanding enabling is not about self-blame. It is about recognizing that well-intentioned behaviors can inadvertently reduce the experiential cost of drinking for the drinker which reduces the natural pressure towards change. This recognition creates the possibility of doing things differently, not out of punishment of the partner, but out of clarity about what actually creates conditions for change.
"Enabling is almost always motivated by love, protection, or exhaustion, not by intention to perpetuate the problem. But behaviors that reduce the natural consequences of drinking reduce the experiential pressure toward change. Recognizing the difference between supporting the person and enabling the drinking is the first step toward a more effective and less exhausting position." — Meyers & Wolfe, 2004; CRAFT framework
What Does Not Work: The Approaches Most Partners Try First
The research is fairly consistent about which partner approaches are ineffective for the midlife high-functioning drinking pattern and they are, not coincidentally, the approaches that feel most intuitive.
Confrontational ultimatums without follow-through. Telling a partner they need to stop or you will leave, and then not leaving, teaches the drinker that the consequence is not real. Repeated confrontations that do not result in changed behavior by either party progressively reduce the credibility of any future limit. This does not mean that limits are wrong; it means that limits only have leverage when the partner is genuinely prepared to enact them.
Arguing while the partner is drinking or intoxicated. Attempting to have a substantive conversation about drinking while the person is intoxicated is reliably counterproductive. The neurological state of intoxication is not a state in which insight, emotional regulation, or behavioral commitment are accessible. The conversation produces defensiveness, escalation, or agreement that evaporates by morning. The same conversation attempted while sober, at a neutral time, in a calm rather than accusatory tone, has meaningfully better outcomes.
Controlling and monitoring. Keeping track of bottles, watering down drinks, hiding alcohol, and strategically not purchasing it rarely reduces drinking in a sustained way because it treats the behavior rather than the underlying drive. A person with AUD will find a way to drink if the underlying condition is not addressed. The monitoring also places the partner in a surveillance role that is corrosive to the relationship and deeply exhausting to maintain.
Al-Anon as a standalone response. Al-Anon provides community, shared experience, and the foundational message of releasing control all of which are genuinely valuable for partner wellbeing. Research comparing Al-Anon facilitation to CRAFT (described below) consistently finds that CRAFT produces higher rates of treatment entry in the drinking partner. For partners whose primary goal is to help their loved one access treatment, Al-Anon alone is not the most effective strategy, though it may be a valuable adjunct.
CRAFT: What the Evidence Actually Supports
Community Reinforcement and Family Training — CRAFT — is the best-evidenced approach for concerned significant others (CSOs) of people with alcohol and substance use disorders who are not yet ready to seek help. A meta-analysis of 11 studies found that CRAFT was twice as effective as control or comparison conditions in engaging the person with AUD into treatment. In direct comparisons, CRAFT produces two to three times the treatment entry rate of Al-Anon facilitation or traditional confrontational intervention.
CRAFT is not an intervention in the confrontational sense. It is a structured skills-training approach for the partner, teaching communication strategies that reduce conflict while increasing the probability that the drinker will accept help, strategies for allowing natural consequences to occur rather than buffering them, and self-care skills that address the partner's own wellbeing independently of the drinker's choices. CRAFT explicitly rejects the confrontational, crisis-forcing model and works instead with the natural reinforcement contingencies of everyday life.
The core principles of CRAFT: allow natural consequences rather than removing them; use positive communication to invite rather than pressure treatment; identify and build on moments when the partner is motivated; take care of yourself as a primary clinical goal, not as a precondition; and work with a skilled clinician rather than attempting to implement the approach alone. CRAFT can be delivered in individual therapy for the concerned partner while the person with AUD does not need to be present or even aware of the treatment.
"CRAFT — Community Reinforcement and Family Training — produces two to three times higher treatment entry rates for the person with AUD compared to Al-Anon facilitation or confrontational intervention. It teaches the concerned partner specific skills for changing the relational environment in ways that increase the probability of treatment entry without confrontation, ultimatums, or enabling." — Meta-analysis of 11 studies; Roozen etal.; Meyers et al.
When Couples Therapy Is the Right Route
For couples where both partners are willing to engage, couples therapy is one of the most effective routes to both reduced drinking and improved relationship functioning. Behavioral Couples Therapy (BCT) — the approach with the strongest evidence base for alcohol use disorder — has been shown in multiple studies to produce greater abstinence and better relationship outcomes than individual treatment alone. BCT reduces domestic violence, improves the emotional functioning of the couple's children, and produces lower relapse rates than individual-only approaches.
BCT works through two primary mechanisms: building behavioral support for the recovery goal (through what the research calls a Recovery Contract — a daily couple ritual that involves both partners in maintaining sobriety), and improving the overall relationship through increased positive activities and structured communication skills. The relationship improvement is both a means to recovery and a goal in its own right: a better relationship reduces the relational stress that drives drinking, and reduced drinking allows the relationship to function at a level that supports continued recovery.
For midlife couples navigating a drinking problem, couples therapy has particular value because the drinking is rarely the only issue. The midlife context including identity renegotiation, the strains of the sandwich generation, career transitions, hormonal changes, the accumulation of relational grievances can all contribute to the relational environment in which the drinking is embedded. Therapy that holds the drinking and the relationship context simultaneously is more effective than treating the drinking in isolation from the relationship that surrounds it.
Emotionally Focused Therapy (EFT), my primary couples modality, provides a complementary framework by attending to the attachment layer beneath the drinking and the conflict. The partner who drinks is, in many cases, a person whose primary attachment strategy for managing anxiety and pain has become chemical.
The partner who confronts or monitors or threatens is, in many cases, a person whose attachment anxiety about losing the relationship has produced responses that inadvertently perpetuate the cycle. EFT addresses both simultaneously, creating the conditions for a different conversation than the one the couple has been having.
What You Need for Yourself
One of the most important clinical points for partners of people with escalating alcohol use is also the most frequently overlooked: your own wellbeing is not a secondary concern that waits for resolution of the drinking problem. It is a primary clinical priority in its own right.
Research on partners of people with AUD documents significant and specific health burdens: higher rates of depression, anxiety, stress-related physical illness, and social isolation. Partners absorb the emotional dysregulation of the drinker, manage the consequences that the drinker does not manage, maintain the household and family functioning that the drinker has withdrawn from, and typically do all of this without telling anyone because the stigma around substance use in the midlife professional partnership extends to the partner as well. The silence that protects the drinker's professional reputation also isolates the partner from the support they need.
Individual therapy for the partner, independent of any decision the drinker makes, is a legitimate and important clinical route. It provides a space to process the anger, the grief, the exhaustion, the ambivalence about the relationship, and the specific question of what the partner is and is not willing to sustain. It builds the psychological resources, the clarity, the groundedness, the self-knowledge, that make more effective engagement with the drinking partner possible. This addresses the partner's own life, not only their role as the non-drinking half of a drinking relationship.
Setting and holding a limit, a real one, with real consequences, is not punishing your partner. It is honest communication about what you can and cannot sustain. The research shows that clear, consistently held limits are associated with better treatment outcomes for the drinker. They are also associated with better outcomes for the partner, because they reduce the exhausting ambiguity of a position that is neither accepting nor actually changing anything. You are allowed to decide what you are and are not willing to live with. That decision belongs to you.
"Your own wellbeing is not a secondary concern that waits for the drinking problem to resolve. Research documents that partners of people with AUD carry significantly elevated rates of depression, anxiety, and stress-related illness, often in complete silence. Individual therapy for the partner, independent of any decision the drinker makes, is a primary clinical priority in its own right." — O'Farrell & Clements, 2012; Behavioral Couples Therapy research
A Note on Safety
If alcohol use in your relationship is associated with any form of physical aggression, intimidation, or threat, the clinical calculus changes significantly. Alcohol is strongly associated with domestic violence, and the approach to partner engagement in a context of physical safety concern is fundamentally different from the approach described in this article. If physical safety is a concern, please speak with a domestic violence advocate or a clinical provider who specializes in this area before implementing any of the approaches described here. Your safety is the first priority.
About the Author
Dr. Julie Rashkis is a licensed psychologist, Menopause Society Certified Practitioner, and Emotionally Focused Therapy trained couples therapist with over 20 years of clinical experience. She works with both individuals and couples navigating the intersection of midlife substance misuse and relationship strain, understanding that these are not separate problems and that the most effective treatment addresses both.
She is the founder of Therapy for Midlife, a virtual practice licensed in California and Wisconsin, seeing clients across all PSYPACT-participating states.
www.therapyformidlife.com | Book a free consultation
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