Therapeutic approaches to the alcoholic marriage

Formulation of a therapeutic approach to the alcoholic marriage requires both an understanding of the theoretical conceptions of spouse pathology, and an understanding of the disease of alcoholism. Theories of psychopathology in the spouse (wife) of the alcoholic were reviewed and found deficient in the light of more objective research. Failure to confirm discreet, specific personality traits in wives of alcoholics parallel similar efforts in the search for an "alcoholic personality." The stress theory of spouse psychopathology enjoys clinical support and a moderate research underpinning. Emphasis is placed on the need for the psychiatrist to be prepared to diagnose alcoholism when evaluating a troubled marriage. The importance of the disease concept of alcoholism and the necessity of establishing conceptual priorities are reviewed. Treating the disease of alcoholism first, followed by marital therapy, is recommended. The treatment of the alcoholic will be more successful if the spouse or family are included in the initial evaluation and subsequent treatment plans.