“Who’s gonna love a junkie? But he does”: Exploring couples’ identity negotiations and dyadic coping in the context of opioid use disorder

Abstract

Opioid use disorder (OUD) is a leading cause of accidental death in the U.S., and people with OUD may rely on romantic partners to dyadically cope with their illness. Guided by the communication theory of identity, this study examines the identity tensions experienced by couples managing OUD and how identity negotiations contribute to couples’ efforts to dyadically cope with OUD. Semi-structured interviews were conducted with 19 dyads and 6 individuals ( N = 44), all of whom were in relationships in which at least one partner was managing OUD. Analyses revealed that couples managing OUD experience three types of identity gaps: personal–relational, relational–enacted, and relational–communal identity gaps. These gaps coalesced around a central theme of couple identity paradoxes, which demonstrated the opportunities and potential downsides of dyadically coping with OUD. Findings deepen theoretical understanding of identity negotiation in couples and the role of relational identities in managing illness.

“I changed, I had to realize that I was wrong”: Identity gap management amidst evolving illness uncertainty

“…In response, interviewees closed identity gaps and aligned personal, relational, and enacted frames; they also maintained identity gaps by placing responsibility for identity change on family members. This research adds to a rich and growing literature exploring the intersection of identity and health in family relationships over time (e.g., Crowley & Miller, 2020).…”

“…Family member's poor character. Some participants maintained their identity gaps by ascribing negative character traits to family members (see also Crowley & Miller, 2020). Ascriptions ranged from suspicions and beliefs about malingering and substance abuse to attacks on the family member's character.…”

“…Specifically, ascribing family members as having negative character traits not only justified participants' doubt and doubt responses, but also positioned participants as superior in the relationship. Consequently, as "good" family members, participants' identity gaps were justified; rather, the locus of turmoil associated with identity gaps was located within their family member's "bad" personal identity, effectively casting family members as (un)deserving of participants' support and empathy (Crowley & Miller, 2020;Thompson & Duerringer, 2020). Family member's failed relational role(s).…”

“…Individuals define themselves by their perception of how others see them (ascribed), through their relationships with others (e.g., brother and friend), in relation to their other identities (e.g., being a mother and a daughter), and as the relationships to which they belong (i.e., dyads, such as couples, incorporate the relationship into their own identity; Kennedy-Lightsey et al, 2015; Merrill & Afifi, 2017). Finally, the communal frame refers to identities born of group characteristics or identities ascribed by society (e.g., stigma associated with drug abuse, depression; Crowley & Miller, 2020; Hecht, 1993; Jung & Hecht, 2008). Although the four frames are distinct identity layers, as frames coexist and interpenetrate, they must be considered collectively (Jung & Hecht, 2004).…”

“…Identity gaps can also be a source of relational strain as they are associated with declines in satisfaction (Kennedy-Lightsey et al, 2015; Pusateri et al, 2016), closeness, liking, commonality, and trust (Morgan et al, 2020), and decreases in intentions to enact relationally oriented behaviors in families (Phillips et al, 2018). Consequentially, people may manage identity gaps to relieve negative affect, improve communication satisfaction, attend to their relationships, and resist negative stereotypes (e.g., Crowley & Miller, 2020; Stanley & Pitts, 2019). In some situations, individuals may choose to maintain or adapt to identity gaps, such as when shared identities can harm health (e.g., enabling addiction in couples; Crowley & Miller, 2020); when identity gaps are positively valenced (e.g., projecting a socially desirable identity; Kam & Hecht, 2009; Stanley & Pitts, 2019); and when identity gaps among some identity layers preserve relational harmony and alignment among other identity frames (Stanley & Pitts, 2019).…”