The addict's choices and behavior are consistently erratic. The individual is able to resist use or behavior more or less well, and then loses containment and uses or acts out. Sometimes, it is a few days, a week, or a couple or several months. The energy expended to abstain may be minimal to overwhelming. It may go smoothly or become highly complicated with multiple other persons involved. Acquiring the substance or setting up the compulsive behavior can get convoluted and require lies to loved ones and subsequent betrayals. Or, can go on autopilot like a brainless morning routine. The mental process of the addict also becomes erratic or destabilized over years of addiction. It adapts in order to convince him or herself that the use or behavior is somehow permissible, under control, or not causing problems. The labyrinth of distortions to continue use or behavior mixed with positive motivations to stop and be a better person is deeply embedded. The individual is as addicted to his or her self-serving story as much as he or she is addicted to his or her substance or compulsive behavior. The therapist needs to aid the individual and couple break down or work through the "stinkin' thinking" that excuses and justifies, and most critically reinforces and sustains the substance abuse or behavioral excesses. Skipping or forgoing developing behavioral stability is a therapeutic error. Establishing behavioral stability without stabilizing the thinking or cognitive process also will not work. Therapy however may not operate in a simple sequential and progressive process whereby the therapist can work solely on cognitive or behavioral stability in lieu of other therapeutic work. The conceptual need to approach change developmentally is complicated by the inherent erratic and objective irrationality of the addict. The therapist should take and work from these principles within the swirling world of the addict. The therapist will out of necessity make unanticipated judgments and choices from such principles that will probably result in unplanned creative therapeutic communications and interventions.
A major consequence of the instability inherent in a relationship with an addict is the deterioration or devastation of trust between the partners. For example, "The primary issue reported by couples recovering from a sexual addiction was the need to regain trust. Only 14% of addicts' spouses reported being able to trust their spouse completely. Significantly, 'trust' is likely the lay term or expression for conveying the dynamics of secure attachment. More than mere honesty, trust references consistency and fidelity in a spouse's (attachment) availability and responsiveness. Thus, when speaking of damaged or forfeit 'trust,' couples are likely referencing an experience of attachment rupture and trauma. Notably, this was designated the most significant consequence of sexual addiction" (Zitzman and Butler, 2005, page 314). Loss of trust and the need to regain trust is important for all relationships harmed by addiction- not just sexual addiction. The process of couple therapy will however, itself uncover more secrets and betrayals that the co-addict was unaware of. Or, the depth and breadth of betrayals may become more painful in the bright light of couple therapy. The denial system may break down or the veil of deception may drop in therapy. Or, the co-addict may finally see through the addict's instinctive evasions, distortions, and outright lies responding to the therapist's scrutiny and inquiry. The co-addict may have been deceived from the finely honed lying skills of the addict along with the co-addict's desire to maintain the illusion of normalcy and hope. As the addict gets focused on charming or fooling the therapist and weaves a pretty and elegant web of deceit, he or she may forget that the co-addict lived the reality along with him or her… and knows what actually happened versus what the addict tells the therapist.