It’s no secret that women are different from men, so intuitively it makes sense that women might benefit from a different approach to recovering from an addiction. After all, women often have unique issues that may affect their treatment, such as pregnancy or infertility, birth-control choices, motherhood, menopause and the like. To assess whether you might benefit from gender-specific treatment for an addiction, ask yourself the following:
- Do I have a history of depression, anxiety or post-traumatic stress disorder (PTSD)?
- Do I struggle with my body image and/or disordered eating patterns?
- Do I have problems with sexual desire or performance or low sexual self-esteem?
- Have I been physically or sexually abused?
- Do I have control issues in romantic relationships?
- Has a partner’s substance abuse influenced my drinking or drug use?
- Do I tend to seek comfort and safety in sexual relationships?
- Do I need on-site childcare in a substance-abuse program?
All of these factors can affect a woman’s needs in treatment and her ability to respond to it, explains Raven James, PhD, an associate professor in the Addiction Studies Program at Governors State University, in Illinois. Perhaps because women often have a greater focus on relationships and a need for connection, they tend to put their needs behind those of the children and men in their lives, especially if they want to please a controlling partner, Dr. James adds.
Other factors that raise a woman’s risk for addiction include: “Skin hunger — which refers to the need to be touched — is another key difference as women are socialized to find comfort and safety in relationships,” James explains. “Women often learn at a young age that they can gain attention from men by engaging in behaviors that involve touching and sex, and this can present itself through sexual risk-taking behavior and initiation into sexual behaviors that are linked to substance abuse if the partner is abusing substances.” These areas can create fertile territory for addiction and relapse.
Moreover, “women who have substance use disorders are more likely to have been physically or sexually traumatized and subjected to interpersonal violence,” James notes. Indeed, in a 2011 study involving men and women with alcohol dependence, researchers at the University of Cincinnati College of Medicine found that the severity of childhood trauma, the number of lifetime experiences that evoked fear or helplessness and the number of current trauma-related symptoms all predicted relapse in women, but not in men. Complicating matters, women with substance abuse problems also are more likely to have mood disorders such as depression, anxiety and panic attacks, adds James.
How Women-Specific Treatment Can Help
In order for addiction treatment to be effective, it needs to address all these contributing elements, James says. That’s where gender-specific treatment comes in. Besides treating the addiction directly, a woman-specific treatment program should address mood disturbances (like depression and anxiety, in particular), relationship issues, sexual matters, food and body-image issues and reproductive and child-care concerns.
Women themselves have identified several characteristics of therapists and counselors they believe makes their treatment more successful, says James. These include “a projection of acceptance and care, trust and warmth, a non-authoritarian attitude and a sense of confidence” in the therapist’s abilities and in their client’s recovery. “Women are more likely to respond to non-confrontational approaches than men are,” she adds. They generally prefer a collaborative approach, one that offers a sense of give-and-take through the process, rather than an authoritarian, do-this-do-that dynamic. Women also thrive with an approach that helps them develop and maintain strong, healthy connections to family members and friends during their inpatient or outpatient treatment for addiction.
Above all, “women need a treatment environment that is supportive, safe, constructive, optimistic and nurturing,” James says; a program with this kind of environment will help set them up for recovery success. To that end, many women prefer female-only settings because these often provide more freedom and safety to talk about difficult subjects such as disordered eating patterns, depression and anxiety, abuse and relationship issues. While most women do prefer female counselors, “encouraging, supportive, hope-promoting male counselors can be beneficial,” she adds, especially if they allow women to be autonomous (rather than treating women as subordinates) and foster a sense of empowerment in their female clients. These are qualities to look for in a therapist and in a woman-centered treatment program.
Unfortunately, there isn’t a central organization that can refer women to gender-specific programs, but the National Institutes of Health has developed a standard of care for gender-specific women’s services for addiction. A good place to start is to seek recommendations from your primary care physician, a therapist or a friend who has gone through women-specific treatment for addiction, if you know someone.