The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.
J Psychiatr Ment Health Nurs. 2021 Oct;28(5):783-793. doi: 10.1111/jpm.12753. Epub 2021 Apr 15.
Alcohol addiction is manifested by periods of abstinence and relapse in which the individual returns to previous problematic alcohol use. This may lead to unstable and stressful routines for the family and for women who live with a spouse diagnosed with an AUD. AUD may mentally and physically affect women living with a spouse diagnosed with AUD with respect to relapse. However, most studies have focused on the influence of AUD in general, and the way they cope with it; few have dealt with the experience of relapse as a distinctive stage.
Women's experiences of their spouses' relapses are embedded within their broader life experience in the shadow of alcohol addiction. The pattern of transitions from closeness to distance in the ways women think, feel and actively respond to their spouses' relapses shows similarities with the ways in which individuals cope with repeated trauma. This helps relate these women's experiences of their spouses' repeated relapses to the potential complex trauma these women experience and leads to a better understanding of the internal emotional dynamics of these women's behavioural patterns.
These women need a therapeutic solution that can help them cope with longstanding emotional burdens. Therapists should be sensitive to the complexity of their experience. When relevant, therapy should be based on therapeutic strategies from trauma practice, along with Alcohol Behavioural Couples Therapy that can reinforce the couple's mutual efforts to achieve sobriety or reduce AUD severity ABSTRACT: Introduction Alcohol use disorder (AUD) is manifested by periods of remission and relapse which can serve as a source of continuous stressors on the individuals and family. Women living with a spouse diagnosed with AUD can be mentally and physically affected by this behaviour. Most studies have focused on the general influence of AUD on these women and their attempts to cope with AUD; there are scant data on the influences of relapse as a distinctive stage. Aim To better understand how women whose spouses are diagnosed with AUD experience their relapses. Method A qualitative-naturalistic approach was implemented. Semi-structured, in-depth interviews were conducted with 12 women whose spouses were diagnosed with AUD. Results Content analysis revealed three main categories representing the transitions from: a) ignorance to realization, b) emotional opposition to acceptance and c) activity to inactivity. Each category reflects one cognitive, emotional or behavioural dimension of this experience. The overarching theme emerged as shifts from closeness to distance in the way these women think, feel and actively respond to their spouse's relapses and addiction. Discussion The shift from closeness to distance as manifested by the three transitions is argued to reflect the ways these women experience and cope with the chronic nature of AUD. It is suggested that this experience parallels the phenomenology of symptoms of complex trauma. Implications for practice Nurses should be alert to the potential accumulative stressors experienced by these women and implement intervention strategies developed in the trauma field in addition to Alcohol Behavioural Couples Therapy.
酒精成瘾表现为戒断期和复发期，个体在此期间会恢复到之前存在问题的饮酒行为。这可能会导致家庭和与被诊断患有 AUD 的配偶一起生活的女性不稳定和压力重重。 AUD 可能会在复发方面对与被诊断患有 AUD 的配偶一起生活的女性的精神和身体产生影响。然而，大多数研究都集中在 AUD 的总体影响以及他们应对 AUD 的方式上；很少有研究涉及复发作为一个独特阶段的经历。
女性对配偶复发的体验根植于她们在酒精成瘾阴影下更广泛的生活经历中。女性思考、感受和积极应对配偶复发的方式从亲近到疏远的转变模式与个体应对反复创伤的方式相似。这有助于将这些女性对配偶反复复发的体验与这些女性经历的潜在复杂创伤联系起来，并更好地理解这些女性行为模式的内部情绪动态。
这些女性需要一种治疗方法来帮助她们应对长期的情感负担。治疗师应该对她们的经历的复杂性保持敏感。当相关时，治疗应该基于创伤实践的治疗策略，以及可以加强夫妻双方共同努力实现戒酒或降低 AUD 严重程度的酒精行为夫妻治疗。
介绍 酒精使用障碍 (AUD) 表现为缓解和复发期，这可能成为个体和家庭的持续压力源。与被诊断患有 AUD 的配偶一起生活的女性可能会受到这种行为的身心影响。大多数研究都集中在 AUD 对这些女性及其应对 AUD 的尝试的一般影响上；关于复发作为一个独特阶段的影响数据很少。目的 更好地理解被诊断患有 AUD 的配偶的女性如何体验他们的复发。方法 采用定性自然主义方法。对 12 名被诊断患有 AUD 的女性进行了半结构式深入访谈。结果 内容分析揭示了三个主要类别，代表了从：a）无知到认识，b）情感反对到接受，c）活动到不活动的转变。每个类别都反映了这种经历的一个认知、情感或行为维度。出现的总主题是这些女性对配偶的复发和成瘾的思考、感受和积极反应方式从亲近到疏远的转变。讨论 从三个转变中体现出来的从亲近到疏远的转变被认为反映了这些女性体验和应对 AUD 慢性性质的方式。有人认为，这种体验与复杂创伤症状的表现相似。实践意义 护士应该注意到这些女性经历的潜在累积压力源，并实施创伤领域开发的干预策略，除了酒精行为夫妻治疗。
