Many problem drinkers are unable to admit to this problem. The cry for help may therefore come from someone close who suffers as a result. The cry often comes at a time when he or she is unable to cope any longer with the drinker. As such, the drinker may self-righteously feel they do not have a problem as they had been drinking like this for years. They may resist treatment and often blame others for their problems. Many marriages fail at this point. One spouse can no longer tolerate the alcohol and the alcoholic refuses to take responsibility. This makes treatment of alcoholics extremely difficult. 

It is important for people to understand the stages of recovery and that each stage carries challenges that some alcoholics will struggle for a long time to overcome. Five stages of recovery are discussed: precontemplation, contemplation, preparation, action and maintenance.¹
 
The Five Stages of Recovery
 
In the precontemplation stage, the alcohol problem has not yet been identified let alone accepted by the alcoholic. During this stage, their defences, most notably denial, are strong. They actively reject any notion of alcohol problems and show anger towards anyone suggesting a problem. They reject treatment and may rely on the support of their drinking buddies to affirm that they do not have a problem. 

In the contemplation stage, the alcoholic toys with and finally accepts that they have a problem with alcohol. This acceptance can be overwhelming, at times leading to depression and/or anxiety. These intense feelings must be expected and planned for as part of a treatment process.  

In the preparation stage, the alcoholic learns what treatment is necessary in order to recover. Depending on the severity, this can include detoxification, inpatient or outpatient counseling and marital and/or family therapy and possibly even prescription medications. 

The next stage, action, is when the treatment plan is implemented and activities are undertaken to address the alcoholism. The support of family and sober friends is crucial here as alcoholics learn to defend themselves, not from admitting alcoholism, but from being pulled back towards drinking by former drinking buddies. Also crucial at this stage is developing an understanding of one’s own family history that may have contributed to their drinking problems. 

The final stage involves relapse prevention and is referred to as maintenance. This stage is life-long. One of the best-known maintenance programs is Alcoholics Anonymous (AA). This program is based upon self-help, group model. Members meet regularly to manage the challenges of sobriety.
 
Recovery from alcohol starts with clear, blunt information from friends and family, and by trained professionals such as physicians, social workers or psychologists. Some family and even some professionals beat around the bush when confronting an alcoholic. This is music to the alcoholic’s ears. Fuzzy messages allow them to maintain their denial. Thus, one must clearly and fully confront the alcoholic. Clear messages leave no wiggle room.

If you think your spouse has a problem with alcohol:

1. Confront him or her forthrightly. If you are concerned for your safety, then do so in the company of a friend or professional.  

2. Get help for yourself too. Learn about alcoholism, your role in the recovery process and of the impact on your family’s well-being.

3. Recognize that it may take some time if your spouse is in the first stage of recovery. He or she has yet to even acknowledge a problem. This can be an insurmountable challenge for some people.

4. Recognize that alcoholism can pose a risk not only to the alcoholic but also to those around him or her. At all times, make sure children are appropriately supervised and cared for. Alcohol related problems are a major cause for referrals to child protective services.

Lastly, can a therapist help? Yes, but unfortunately, not in all cases. Much will depend on the stage of recovery, the willingness of the alcoholic to change, the social supports available and a good treatment plan.
 
¹ DiClemente, C.C., Bellino, L.E. and Neavins, T.M. Motivation for Change and Alcoholism Treatment. National Institute on Alcohol Abuse and Alcoholism. Alcohol Research and Health .23:2. 1999.

To read more articles by Gary Direnfeld, MSW, RSW, go to www.yoursocialworker.

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The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.

Dr. LeslieBeth Wish, MSS is a social worker based in Sarasota, FL. She has been a speaker for non-profit, corporate and university organizations. Dr. Wish offers sound, research-based relationship advice that makes sense — specializing in issues such as smart dating, women’s relationship advice, career coaching, healthy families, sexual dysfunction, and leadership training.

Dr. Wish is the author of Incest, Work and Women: Understanding the Consequences of Incest on Women’s Careers, Work and Dreams.

Q.  Actress Mackenzie Phillips announced that she had incestuous relationships with her father John Phillips.  How common is this situation?  Do most of these relationships involve father-daughter rather than mother-son?

A:  Although childhood sexual abuse includes mother-child incest, more men commit child-family member sexual abuse.  The most frequent male family offenders are step-fathers, fathers, uncles and grandfathers.

Q.        What are the warning signs?

A:  From a child’s perspective, warning signs include sudden or increased physical contact that might pass as acceptable with a family member.  For example, suddenly Grandpa wants you to sit on his lap more often.  Or, an uncle wants to caress a child’s hair or cheek more often.

Other forms of physical contact are more blatantly sexual, such as Mackenzie Philip’s intercourse with her father.  Childhood sexual abuse can also include fondling of breasts, rubbing up and down against a child and sexual comments.  Children often have a good sense that something is “wrong,” but they may not tell anyone about these sexual experiences.   Children learn rather quickly that the sexual activity with a family member is not normal.

Some offenders make it very clear that if a child reveals their “secret,” the offender will harm the child and/or the family.   Children also come to realize that telling someone puts the family in terrible jeopardy.  What, for example, would Mom do if she knew about it?  Would the family break up?  How would the family get along without Dad?  A great deal is at stake, and no child wants the responsibility of causing a crisis in the family.  If a child does reveal “the secret,” it is not uncommon for other family members to deny or not accept that sexual abuse occurred.

Some siblings, for example, side with the offender, saying that no evidence or hints of abuse exist.  To be fair to these supportive siblings—and even spouses—it is highly possible that the offender kept the secret very well-hidden.  Often, the abuser selects one or two favorite children for sexual and emotional gratification and never violates the other siblings.  As a result, the other siblings never experience or even suspect that abuse is occurring.

Finally, when a family member abuses a child sexually, the abuse is not solely about sex.  Offenders are often looking for comfort, closeness and approval from someone whom, in the mind of the offender, offers an opportunity for unconditional love.  The closeness and need for comfort can rapidly become sexualized.  Many offenders are, however, also looking for sexual gratification, power and control.

Q.        What can be done to protect the child?

A:  All parents and caregivers should talk with each child about sexual behavior that is “wrong.”  Children should be taught early about unwanted touches.  Parents and caregivers should let children know that they want to know about any kind of touching or interaction with someone who makes them feel uncomfortable physically and emotionally or who touches them.

When parents set the emotional rules and establish an environment of care, children are more likely to let a family member know.  Parents can also tell a child that if they are afraid to tell a family member that they can tell another adult whom the child trusts such as a teacher, minister, etc.  (And no jokes, please—yes these two groups have a history of being sexual predators, but there are still good teachers and religious leaders who can help a child in need.)

Q.        What is the likelihood that an incest victim will eventually seek counseling?  Also, when victims seek help do they immediately admit the incest or rather do they come to treatment for issues like alcohol or drug abuse which they’ve sought to cope with the pain of the incestuous relationship?

A:  Statistics can vary about the incidence of abuse, but roughly one in twenty-five women will experience some kind of sexual abuse by the time she is 18.  For men, the numbers are about one in seven or eight.  Since sexual abuse carries such a high degree of shame, it’s highly likely that clients will not mention it.  Substance abuse, as well as suicide attempts, is a failed effort to manage the emotional pain of sexual abuse.

Q.   What type of therapy/counseling is typically used in these cases?

A:  There are many therapeutic treatments, including medication for depression, cognitive therapies and emotional reprocessing therapy where the client learns to come to different conclusions and understandings about the self and the experience.  There are excellent training programs for therapists to learn about these therapies.

Q.   What sort of therapy/counseling is typically used in these cases?

A:  Every person is different, but common, long-term effects include suicide attempts, depression, substance abuse, fear of both emotional and sexual intimacy, promiscuity, prostitution and runaways, lack of career identity, inability to function at work.

Rationalization and Denial
Battering is seen as a victimization of the woman and her responses often parallel those of victims of violent crimes. However, abused women are different from other victims of violent crimes in that the assailant is an intimate and previously trusted partner. The psychological repercussions include loss of a sense of trust and safety and intense feelings of helplessness. There is confusion as the woman attempts to absorb the impact of being hurt by someone who was thought to be caring and protective. High anxiety, passivity and/or apathy often characterize the woman’s response. The women who are more likely to remain in the relationship are believed to engage in a process of rationalization which denies the reality of the situation, the options available, the truth about the victimizer and the victimization, and the causes of the violence.

Profound Consequences
If the woman remains in the situation without taking any action, the abuse is likely to increase in frequency and severity. She may experience something similar to post traumatic stress syndrome. She begins to identify with the aggressor, becomes brainwashed, may cling to her husband or lover and behave in irrational ways. The long-term psychological effects include a profound sense of betrayal of trust, depression, suicidal ideation, guilt, shame and feelings of inferiority. The woman may be extremely afraid for her personal safety. The psychological consequences of battering are, therefore, profound. They cluster around physical symptoms and mixed anxiety/depressive symptoms.

Women who have been beaten and abused are also more likely to attempt suicide.  Women in an abusive relationship use self-blame which imposes meaning on the situation and gives them some semblance of perceived control. Battered women ask the question, “Why now?” They blame themselves for causing the husband to act violently in order to feel as if they have some control over what has happened. But as the violence continues, they begin to blame themselves more and more for not being able to modify it or for tolerating such behavior.

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People begin gambling for different reasons. Perhaps the most common reason is for the entertainment aspect. Many of us who have developed an addiction started just that way. But then for different reasons the entertainment value goes astray, and in my case gambling became a distraction and a way to hide, relax and numb myself to the challenges of everyday life.

I had a great childhood. I grew up here in Morgantown, West Virginia, and after my family moved on, I stayed here to teach school and raise my daughter Erin. Being a West Virginia teacher (where the salaries are low) , I have always had to watch my finances and work extra jobs to get my daughter through college and have a little extra money.

First Experience Gambling

I had never gambled …ever, until I took a trip to Reno, Nevada with my mom to visit my aunt and uncle. They live in Reno, and part of their entertainment is to go to the local Peppermill Hotel Casino and gamble. This was about four years ago. I saved a little money to play and that was all I spent.

Then over the next few years I would visit Atlantic City on the way to my sister Nancy’s in Cape Cod, or stop off at Foxwood Resort Casino in Connecticut, once, for an hour to check it out.

Family Issues

Somewhere in the midst of these years my step-dad died of cancer and my father died suddenly. I helped the family out in both situations by helping plan the funerals and speaking at the services.

Over the next few years my mom had a broken leg, a blocked artery, gall bladder surgery, and a perforated hernia. As a relaxation activity from school and running up and down the road to Charleston, West Virginia, I walked into one of the little casinos here in Morgantown. It wasn’t hard; it was over on University Avenue as are many, many other little gambling spots.  Video poker machines started appearing up in 2000 and can now be found in 99 local establishments.

I started on the weekends after returning from my mom’s, and would just play for an hour and go home, always limiting the amount of money I spent to $20 to $40. Then I started stopping in during the spring of 2004 after school and on the weekends. I would drive around and visit some of the other places here in Morgantown and Westover, West Virginia.

The Big Fall

My big fall into the pit came with the onset of summer 2004. I started out by visiting some of the local places each day. I actually took a class that lasted a week in the middle of all of this, and at that point at least I would like to say that the gambling didn’t interfere with my school responsibilities. I kept it as an after school and weekend activity.

I started playing for fun, a chance to relax, and visit with new people who had similar interests. We discussed wins and losses, family, travel, our health. Everything! It was so much fun. But soon I was out of control.

I started going to the bowling alley everyday. I would have breakfast, get dressed and the excitement in my heart would begin. Would I win today? Could this be the day?

Even now as I think about it, I get excited. I am one of those folks who didn’t win much. I did win $300 one day and $900 on another day, but even though I filled out bank deposit slips, I returned to the gambling establishments and lost that money later on.

I went from gambling just $40 at a time to sometimes $300. I went through my savings, sold coins and jewelry, took out a small loan to pay off my credit cards and then gambled away that money, and then I began to use a pin number to take money out on my Discover Card. The company called me several times to find out if in fact I was taking the money out or had my card been stolen. I told the guy that it was me, and I proceeded to take out the limit on my card.

As the middle of August came, I realized that the only money I had left was the money I had put away in the credit union for the two summer months that I didn’t get paid. So I started using it.

Denying the Problem

All the while, I was denying to my friends and family that I had a problem. I would put a smile on my face and laugh it off. I took one more loan out and by the time the school year started I had 47¢ left in my pocket and 1 credit card that I had not touched.

Your mind goes numb. You don’t think about how much you have spent or you just try to ignore the mounting debt. It becomes a battle of wills. Ignoring what you know is happening to you, and at the same time rationalizing that it will be fine and that you are still in control.

During this summer of 2004 I still called my mom each night, as we had done for years. But sometimes I would be a little late or would run home from the bowling alley and then go back as soon as I finished my call. At the time this felt exciting — like being a child and getting away with something. I had only been talking to my sister Nancy about once a week, which was very unusual for me.

Hitting Bottom and Getting Help from Social Workers

But finally, I hit my my lowest point on August 30th.  My sister asked me if I was mad at her because I had not come to visit her. That was my night to tell. I spilled my guts and cried and cried. She encouraged me to get help. I gambled one more day and on the evening of September 2, 2004,  I called the Gamblers Hotline and talked to Steve who is a licensed social worker with a bachelor’s and master’s degree in social work.  For what seemed like two hours he calmed me down, gave me information and finally, after much cajoling, got me to accept an appointment with a counselor. That was the beginning of my recovery and the acceptance of my gambling addiction.

Friday evening, September 3rd, I met with my counselor, Jane (a licensed, clinical social worker with more than 20 years of experience counseling problem gamblers), for two hours. She asked questions and let me talk and cry, and then we began working on practice sheets that made me take a long hard look at my addiction.

We went through a series of questions that helped me identify the severity of my compulsive gambling, and let me see how through a series of life’s challenges, I had used the gambling as an escape. I met with Jane four days later and we continued to delve into my reasons for gambling and also discussed money management. For several months following we met each week, and as my confidence grew and I remained clean, I began to recover the joy in my life and the fog began to lift.

My sister Nancy and her fiancé Tim called me every night as they have continued to this day. They call themselves the SST (the Sandy Support Team). I will be forever grateful to them for their love and support.

As a way to replace my gambling I decided to go walking with my friend Sandy. I was not going to divulge my secret but on our first lap around the Coliseum I told her my story. What a friendship we have, and she kept my secret until I started to come out to my other friends.

Help from Gamblers Anonymous

There was one more very important part of my recovery and that was Gamblers Anonymous. Jane had encouraged me to go to meetings as another integral part of recovery, but I kept putting it off. I finally went to Stonewall Jackson Resort in Roanoke, West Virginia, where a counselors’ conference was being held and they happened to be having a Gamblers Anonymous meeting. I went with a fellow member and experienced my first meeting September 22, 2004.

An important guest speaker was Arnie Wexler and his wife Shelia. He discussed his path to recovery and the support his wife had made to his remaining clean. They are a wonderful older couple, from New York (I think), and they speak all over the United States. In January a very involved member of Gamblers Anonymous started a group here in Morgantown and I have participated in that group each week.

The power of Gamblers Anonymous is the support. We are all in the same boat, although circumstances and stories are all very different. The one thing we all have in common is an inability to control our gambling. As one of our members said, “Gambling is an inadequate or inappropriate response to a life situation.”

Together we acknowledge that we are powerless over gambling, but with the support of others and taking one day at a time, and sometimes one hour at a time, we are regaining our lives and finding better ways to cope with a very insidious addiction.

Clean for More Than a Year

I have now been clean for more a year. I have money in my saving account. I can shop, a little bit. Life is good, I am happy, I have found my joy once again.

The Hotline is invaluable. They provide a shoulder to cry on but more importantly advice on help. If you let them, they will set up a counselor, send a packet of information and advise you on the location of Gamblers Anonymous meetings.

I will always be grateful to the Hotline and the supportive staff that works there. I enjoyed the follow-up calls at six months and 1 year and I hope that I will be able to speak to them over the years.

* * *

The National Council on Problem Gambling in Washington, DC estimates that two to three percent of our population, or 6 million to 9 million Americans, will suffer from a serious gambling problem in any given year. If you or someone you know needs help with a gambling problem, call the National Problem Gambling Help-line at 1-800-522-4700 or go to www.NCPGambling.org.
National Problem Gambling Awareness Week is March 6-12, 2006.  Hundreds of individuals, professionals, treatment providers, agencies, and gambling and gaming organizations join efforts to create more public awareness about this disorder through a wide variety of screenings, training and public events. For more information, go to please go to www.npgaw.org/021.htm.

Clearly one of the most misunderstood disorders in the field of neuroscience is the diagnosis of “Obsessive-Compulsive Disorder.” It occurs from early childhood all the way throughout the life span.

It is actually a spectrum of disorders generally seen when one cannot get a particular thought out of their conscience mind. They may think they are contaminated, that something horrible will befall someone they love. They may think that they may utter something blasphemous. They may feel convinced that there is something about their body that is misshapen or looks ugly. They may look endlessly in mirrors and ask others of they notice the defect. They may avoid going out, certain that others will notice their defect. The public is generally unaware of the suffering that so many go through dealing with their “stuck thinking.”

Obsessive-Compulsive Disorder has more symptoms than just about any other diagnosis. From the better known symptoms such as those seen in the movie, “As Good as it Gets” with Jack Nicholson, where hand washing and certain rituals were present, to the lesser known symptoms such as “hoarding”, stuck thoughts, and many believe that even anorexia may be a symptom on this wide and unusual spectrum. Clearly one of the most disturbing for some is the, “distress of perceived ugliness,” known as Body Dysmorphic Disorder or BDD.

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Introduction
In 1980, in response to the veterans of the Vietnam War and the militancy of the antiwar movement, the American Psychiatric Association (APA) acknowledged the symptoms of Post Traumatic Stress Disorder (PTSD). The diagnosis of PTSD was then included in the DSM (Diagnostic and Statistical Manual of Mental Disorders). The feminist movement was influential in this development as well due to their advocacy for a diagnosis in recognition of the trauma of rape.

The DSM IV-R (2000) describes PTSD, in short, as the “re-experiencing of an extremely traumatic event that the person has experienced or witnessed, accompanied by symptoms of increased arousal (such as sleep disturbance, irritability, hypervigilance, difficulty concentrating) and by avoidance of stimuli associated with the trauma and numbing.”

Post Traumatic Stress Disorder Related to Combat
After the war in Vietnam was over, some 30 percent of Vietnam combat veterans suffered from PTSD; flashbacks to horrible near-death situations were common. A study conducted in 2003 involved 6,200 soldiers who had served in Iraq and Afghanistan several months before. Research was conducted by a team of social scientists at the Walter Reed Army Institute of Research.

Results showed that one in six of the veterans displayed symptoms of PTSD, major depression, or anxiety; 12 percent had symptoms of PTSD alone. (These figures are an underestimate as the study was done before the far more brutal urban combat efforts got underway.) The risk of developing trauma rose in proportion to the number of instances of combat in which the soldier had engaged.

According to a more recent Post-Deployment Health Reassessment, which is administered to all service members, 38 percent of regular soldiers and 31 percent of Marines report psychological symptoms. Among members of the National Guard, the figure rises to 49 percent. Those who had served repeated deployments were at extremely high risk of problems and the toll on their family members was great.

The exact rate of PTSD in women veterans is unknown. Studies conducted after the Gulf War  concluded that female service members were more likely than their male counterparts to develop PTSD. This is consistent with the 2 to 1 ratio of female to male PTSD sufferers in the general population.

Males with psychological symptoms from battle, however, are three times more likely to be given a diagnosis of PTSD than females, according to the Pentagon Task Force report.

One explanation for this may be cultural expectations that make it difficult for society and mental health providers to recognize women as combatants. Additionally, there is a tendency to diagnose women as having depression, anxiety and borderline personality disorder instead of combat-related PTSD.

For several reasons, the impact of the Iraq and Afghanistan wars is expected to be more severe than the impact of previous wars. (1) The experience of combat, engagement in gun battles, and handling the bodies of dead comrades is a constant in these wars, (2) the experience of killing people at close range is a frequent occurrence, (3) extended lengths of service with only short periods of rest and recuperation in between are taking a psychological toll on soldiers; and (3) many of the injuries in this war are to the brain.

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Also on HelpStartsHere…

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Intimate partner violence is all too common throughout the world and takes many forms. The most serious of these is homicide by an intimate partner. The fear of being killed, in fact, is a major dynamic in male-on-female violence and sometimes in motivating women to kill the perpetrator of abuse out of fear or desperation.

Facts on Domestic Homicide

In the U.S., estimates from the Bureau of Justice Statistics (BJS) are that more than three women a day are killed by their intimate partners. Women are killed by intimate partners more often than by another acquaintance of stranger. Most of these murders involved were preceded by physical and psychological abuse.

Outside the domestic realm, males are killed much more often than females; they are killed most often in fights with other men.

According to the FBI’s Uniform Crime Reports, 1,055 women and 287 men were murdered by their intimate partners in 2005. These figures are striking, because in the past, in the 1970s and earlier, the numbers of men and women so victimized were about even. In other words, there has been a significant decline in the numbers of men killed by their partners but not for women.

The number of men who were murdered by intimates dropped by 75% between 1976 and 2005 (BJS). The number of black females murdered in this time has declined but the number of white females murdered has dropped only by 6%. Statistics Canada (1998, 2005), similarly, reveals a sharp decline in the numbers of male domestic homicide victims but not of female victims of homicide.

The reason that women are resorting less to murder of their partners is most likely because many of these women were battered women who felt trapped in a dangerous situation. Today, the presence of violence prevention programming and the availability of shelters are paving the way to other options. The fact that domestic violence services apparently are saving the lives of more men than women is a positive, though unintended consequence of the women’s shelter movement (see van Wormer and Bartollas, 2007).

Situations of Domestic Murder Suicide

The National Violent Death Reporting System (NVDRS) is a recently developed state-based surveillance system that includes data from 17 states as of 2007. Now for the first time, a national data base exists that reveals the numbers of homicides that end in suicide. The goal is to collect data on homicide for all 50 states. Results so far reveal that over 90% of the perpetrators of murder-suicide are male. About one third of these male perpetuated homicides end in suicide. (Data available at www.nvdrs.com.)

These results are consistent with those of the Violence Policy Center (VPC). The VPC bases their findings on an Internet search of media accounts of deaths by murder-suicide. VPC reports that a total of 591 murder-suicide deaths took place nationwide in the six months between Jan. 1 and June 30, 2005.

As reported by the Violence Policy Center (2005), the pattern of the murder-suicide is predictable: the pattern involves a male perpetrator, female victim, a decision by the woman to leave the man, and a gun. A handgun was used in 92% of the incidents. The offender was 6.3 years older on average than the victim. Texas had the highest number of cases; the typical Florida pattern involved an elderly male caregiver overwhelmed by his inability to care for an infirmed wife.

Some researchers argue that murder is the primary motive in such cases; others point to the double and multiple killings as a form of extended suicide (van Wormer and Bartollas, 2007). The urge to kill can be described as an urge toward total self-destruction including the destruction of the person who rejected him.

The pattern that emerges in these cases involves intimate partners in the 20 to 35-year-old range: The man is abusive, psychologically and/or physically. Obsessed with the woman to the extent that he feels he can’t live without her, he is fiercely jealous and determined to isolate her.

Characteristically, suicidal murderers have little regard for the lives of other people; they would be considered, in mental health jargon, to be antisocial. Yet they are so emotionally dependent on their wives or girlfriends that they would sooner be dead than to live without them. When the girlfriend/wife makes a move to leave, her partner is absolutely distraught in the belief that he can’t live without her.

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Included in the rising divorce rates are long-term marriages. Why, we ask, would someone get divorced after more than twenty years of marriage? Before we take a look at the top reasons for why some long-term marriages end in divorce, let’s first see why some long-term marriages succeed or just “go along to get along.” “Success” means that BOTH partners report being happy.

Good Reasons Why Some People Stay in Long-Term Marriages—What Makes These Good, Happy Marriages Work?

Good, happy marriages consist of people who:

1. Are both truly happy, optimistic people who know how to problem-solve.
2. Tended to get married when older and more settled in their careers/education and more mature.
3. Are financially comfortable.
4. Have college degrees or technical training.
5. Find ways to “renew” the marriage spark. Some couples do this by traveling, taking classes of some kind together, doing a large project together (building a dream house, etc.), volunteering together and basically finding a new shared interest etc.
6. Are happily involved with their grandchildren and/or adult children.
7. Have good health.
8. Don’t criticize and reject each other.
9. Respect and like each other.
10. Have more than “weathered or gotten through” major stresses such as affairs, financial or emotional problems. Instead, they triumph over these issues and grow.
11. Have a wildcard factor—a highly personalized reason for being happy and together!

Make a checklist of which ones are part of your marriage. Now let’s take a look at why some unhappy, long-term marriages continue.

Why Some Unhappy, Long-Term Marriages Continue

1. It’s been said that some marriages keep women off welfare, out of the poor house and out of the mental institution. So, some people stay in bad marriages because divorce or singlehood seems worse than their current situation.
2. Some couples agree to live separate lives while still being legally married. Usually, they agree to this arrangement because of financial and psychological reasons. Psychologically, the spouse serves as an “emotional safety net” in case a partner needs emotional and financial support. Or, the couple might be raising the grandchildren and need to stay together because of them. In fact, some grandparents agree to raise their grandchildren as a way to find joy and to put a “buffer zone” between them and their spouse.
3. The “shame” of divorce is worse than the marriage. Some couples feel social, religious and family pressure to stay married.

Why Some Long-Term Marriages End in Divorce

1. The marriage was never really very good, and they wait to divorce until after the children are older.
2. One person is having an affair—and is discovered. About 25-33% of marriages cannot recover from affairs.
3. One person falls in love with another person.
4. One spouse can no longer tolerate the abuse—verbal, physical or sexual. Abuse is still one of the highest reasons people divorce. Often, one spouse tolerates the abuse for a relatively long time. What makes that person say “enough” is: (a) maturity; the person is in therapy and the help kicks in; (b) one or more of the children are “little adults” who speak up; and (c) the legal system has finally listened or responded—there are charges, trials and/or prison sentences.
5. One person matures and grows out of the marriage. This maturity can be sparked by time, death of a parent or other close person, new job or completion of education/training that makes the more financially dependent spouse able to support him/herself.
6. One partner develops serious problems that do not change. These types of problems include substance abuse, mental instability, felonies and other illegal acts.

Did you see your top reasons in these sections? Think about what you want to do about it. Remember, every marriage is different.

###This article first appeared in www.helpstartshere.org, the award winning consumer Web site of the National Association of Social Workers. To read more articles by Dr. Wish on this site, please click here.

Almost half of the spinal injuries occur as a result of motor vehicle injury, second are falls, and the remainder come from acts of violence such as gun shot wounds or knife injuries as well as war related injury.

SCI is defined as, damage or trauma to the spinal cord that results in loss of sensory and motor function. An SCI can result in either a “complete injury” (a loss of all voluntary movement) or an “incomplete injury” (a partial loss of voluntary movement).

An SCI is classified utilizing a scale developed by the American Spinal Injury Association (ASIA) that uses a system to describe the level of injury. For example, a person with an ASIA A complete injury describes a person who has no voluntary movement or sensation below the level of injury.

Dealing with the Diagnosis

Spinal cord injury (SCI) is a devastating event that not only has physical but social and psychological ramifications for both the individual and the family. In one moment, a person’s world is monumentally changed forever with reverberations throughout the whole family system. The person who sustains an SCI is at high risk for many factors including: dependency, depression, drug addiction and, if married, divorce. They can also struggle with debilitating secondary medical complications and other factors such as the effects of perceived social discrimination, declining help and lack of social, family, and emotional support.

Family Implications

When something traumatic happens to one family member, the whole family feels the effects. Roles and responsibilities change. Marital strain occurs when one partner has to take on unfamiliar roles such as providing assistance with activities of daily living, financial responsibility and intimacy changes. This can put the person without the disability at high risk for depression.

Parents who have a young adult child that has an SCI will often reestablish the role or responsibility of parenting. If the person has left home, this may mean moving back in. This can affect self-esteem of the person with SCI and cause conflict with parents.

Interpersonal relationships are affected as well. Friends who may have had previous interests or activities they enjoyed doing together are now different. The person with SCI may withdraw or may feel embarrassed being seen post-injury. While having a young child sustain a spinal cord injury, brings a new dynamic to the entire family system and numerous challenges to the child who must face an SCI during times of dynamic growth and development.

Phases of Adjustment

When a person, and by association, a family, experiences a traumatic event, they will experience a series of emotions or phases. These phases are used as a guideline to understanding this overwhelming emotional process. It is important to note that the person with SCI may be in one phase and the family in a different phase during the same period of time. It is critical to keep lines of communication open and to allow everyone to experience this process at their own pace.

Initial phase

The first stage is a general sense of denial or disbelief stage. This process is a built-in defense mechanism to help us cope with extremely stressful situations. It is a normal process and is usually helped by getting more information. This first step on the road to adjustment is characterized by absorbing information, learning new tasks for care, and understanding what is lost and what is left.

Middle phase

The next phase is usually characterized by more emotional responses such as guilt, anger, and depression. Someone may experience feelings of anger or may displace the anger they feel about the injury onto someone else. A person with an injury may feel guilty, especially if careless or reckless behavior was the cause of the injury. They may also now perceive themselves as a burden to the family. Depression is associated with the losses endured by everyone going through this experience. Whatever the emotion, a person with a SCI or family member should be supported and validated. If symptoms become severe, professional counseling is appropriate and recommended.

Adjustment Phase

This phase can be short or last a lifetime. Generally, during this phase the injured person becomes more familiar with living with an SCI. They may gain independence at a wheelchair level with regard to self-care or may adjust to having a caregiver. During this phase, one generally returns to activities they were doing before an injury such as: socializing, driving, employment/volunteering, and adaptive recreation.
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