My 32-year-old girlfriend of two years has an identified alcohol abuse problem. I don't. She doesn't have a dependency issue, but in recent years (which have been better than non-recent years), she loses control and blacks out a minimum of once a month. Her blackouts have led to destructive/dangerous behavior ranging from hurtful conversations to compromising her work to cheating (not on me) to unsafe transportation.

For about six months she's been following a moderation management program and has some success (blackouts down by half, vastly improved drinking habits). But occasionally, even if it doesn't get to that extreme point, she'll abandon her strategies and over-drink, often as a reward for something or as a means of momentary escape from stress. When this happens, I feel sad, frustrated, and disconnected - beyond the deflated faith in our future that comes with the fear that she won't get this under control, she has a history of expressing extreme feelings (one way or the other) about me and our relationship while drunk, and also of forgetting the (often wild and fun and seemingly connected) sex we've had when she's drunk (maybe it's worth mentioning here that I'm also a woman, and she's usually the top).

Before I really understood this about her, it would just make me feel kinda shitty and used and guilty and lonely. So, I no longer engage in sex or meaningful conversations with her when she's drunk, and I feel myself closing off to her when she has these slips.

She feels like I'm too hard on her for not understanding that she deserves to "relax" a little sometimes and that I should applaud the major improvement (and I otherwise do) rather than retreat when she decides (as she puts it) to take a night off.

It's probably the biggest issue between us (and we're often long-distance, in different time zones working in demanding creative fields, so that's saying something). We love each other deeply, and our relationship is otherwise good. She wants to marry me. I can't do that if this doesn't get resolved. I don't know what my limit is. I want to be with her, I know substance abuse issues are complex, and I want to be patient and hopeful and compassionate and supportive, but I'm finding it just really fucking hard to do without also feeling like I'm compromising what I want in a shared life. How in the hell do I do that?

Will A Substance Take Everything Down?

"Unsafe transportation" is a delicate way of saying "drunk driving," WASTED, and twelve black out episodes per year is a fuck of a lot of blacking out. So if this is one of her better years... geez. I'm amazed she survived the bad years. (To say nothing of the other drivers and endangered pedestrians who crossed her boozy path.) Your girlfriend, right now, has a very serious drinking problem and needs help. Since substance abuse isn't my area of expertise — use, yes; abuse, no — I shared your letter with therapist and counselor Katy Leach, who runs Seattle's Synthesis Counseling. Take it away, Katy...

I like this letter because it illustrates the complexity of interacting with others through the lens of harm reduction concepts such as moderation management. In contrast to the firmly defined roles and rules of abstinence-based models associated with 12-step and other chemical dependency theories, harm reduction seeks to minimize the consequences of use for both the person managing their substance use and others who may be affected. It sounds like the LW has a pretty clear-eyed understanding of how substance use is showing up in her relationship, and is committed to supporting her partner in moving toward her goals at her own pace and style.

Working with loved ones around any area of concern or focus, including substance use, often comes back to each person figuring out and asserting boundaries that support their own well-being. When I work with clients as they explore boundaries I encourage them to reflect on the intention behind each limit or boundary they are defining for themselves. A boundary created with an intention or wish to control someone else’s thoughts, feelings, or behaviors indicates that there may be more work to do around enmeshment, or fuzzy boundaries.

The LW provides an example of what sounds like a clear boundary she has already established: “I no longer engage in sex or meaningful conversations with her when she's drunk.” It sounds like that’s part of the work she’s done to protect herself from harm (feeling “shitty and used and guilty and lonely”). I encourage her to explore how this boundary supports her needs, and whether the boundary could be expanded or clarified to be even more effective. This work is, as the letter writer point out, complex and difficult. My hope for both parties is that they are each working with a therapist who is versed in harm reduction and can support them in maintaining whatever health looks like for them.

Thanks, Katy! That was — and I mean it — helpful and clarifying, empathetic and insightful counsel. But not proscriptive. Professional counselors rarely tell people what to do; instead, they ask people to think about what they want or might need to do. Advice columnists, on the other hand, are in the telling-you-what-do business. So I'm gonna tell you what to do, WASTED: RUN.

If your girlfriend is driving drunk and blacking out and telling you she only drinks when she's stressed or has something to celebrate (and demands praise for not blacking out or driving drunk on a daily basis!), WASTED, then she's essentially telling you she has no intention to stop drinking to excess ever. Period. Since life is one stressful event after another broken up by the odd reason to celebrate, WASTED, and since married people spend a lot of time together in cars... I'm gonna tell you again to break up with this woman. And don't say, "It's not you, it's me," on the way out. Don't soften the blow. Do her the favor of telling her it's her. Not you. Specifically her drinking — which, considering you two are long-distance right now, is almost certainly worse than you know. Maybe losing you will inspire her to get the help she needs.