Gender, Part Two---Gender in Recovery, Part Two

In my previous post I wrote about a piece of research that found gender and marital status seem to enhance or lessen the likelihood of long-term sobriety. Specifically, the researchers found that 8 years after completing treatment, married men and unmarried women were more likely to be clean and sober, while unmarried men and married women were less likely to remain abstinent. In that post I wrote about why married men are more likely to stay clean and sober than unmarried men.

Today's post is about why unmarried women seen to do better in recovery than married women. Joan and Hank are a couple who illustrate the difficulties married women encounter in recovery. When they came to see me, Joan had about 18 months of sobriety. They called me because they were having trouble with the sexual part of their relationship. Joan had met Hank in a bar when she was still drinking and quickly fell into a sexual relationship with him. Before she got sober, she and Hank usually split a bottle of wine and/or got stoned before going to bed for sex. Both Joan and Hank reported that Joan had been very involved in their sexual encounters during this part of their relationship, and both of them spoke about how delighted they both were with the sexual part of their relationship.

Joan surrendered to the reality of her alcoholism, attended a 30-day outpatient program, and began going to AA meetings about 6 months after she and Hank got married. Her discomfort with sex, which actually began shortly after the wedding, escalated after she got clean and sober to the point that she had begun to dread the times when Hank approached her for sex. Hank, who was still drinking and using pot on the weekends, was frustrated and impatient with Joan about her lack of sexual desire. He blamed the situation on Joan's participation in AA, saying Joan was being influenced by "those AA dykes who hate men." Needless to say, Hank's attitude and behavior only added to Joan's difficulties in wanting to be sexual.

As we explored Joan's past, I realized that Joan had probably been sexually abused by her dad's alcoholic brother. Joan acknowledged how her uncle would always want her to sit on his lap and give him a kiss when he visited and how he made sexually inappropriate remarks in her presence, but she had no memory of any direct sexual encounters. It was clear, however, that talking about this uncle stirred up angry and unhappy feelings. When Joan married Hank, some of these feelings began to emerge when she and Hank were making love; they became much stronger after she sobered up.

Joan's probable sexual abuse (I would label her uncle's behavior as sexually abusive even if he never had intercourse with her or persuaded her to perform oral sex on him) is not at all uncommon for women who have become addicted to alcohol or drugs. In fact, my wife, S, who is also a therapist, has worked with at least 200-300 alcoholic/addict women over the past 25 years, and EVERY SINGLE ONE OF THEM was either sexual abused or the victim of unwanted, inappropriate sexual behavior before becoming adults. Drinking alcoholically and/or using mind-altering drugs became a way of coping with the pain, anger, and shame these women experienced as a result of the abuse.

A common coping mechanism for people who have been sexually abused is to split off sexual feelings from the feelings of emotional vulnerability. It is as if a person can be sexual as long as their is no commitment to an ongoing deep emotional connection. But when an alcoholic woman who was sexually abused as a child marries and also sobers up, she is suddenly quite vulnerable emotionally, opening herself up to the pain, anger, and shame of her sexual abuse whenever she and her husband try to make love. One way to avoid these feelings is to shut down her sexual desire; hence Joan's loss of sexual interest in Hank after they married and she got sober.

Hank's response to Joan's apparent loss of libido only made things worse. She was trapped between stirring up uncomfortable feelings if she engaged in sex and being the recipient of Hank's anger and contempt if she didn't. It is not surprising, therefore, that Joan went back out and resumed drinking a few weeks after she and Hank began seeing me. It was the only way she knew how to cope in a marriage that neither supported her sobriety nor helped her work through her childhood history of sexual abuse. I suspect this kind of situation is one the primary reasons that married women are less likely than unmarried women to achieve long-term sobriety.