Individual & Relational Work for Addiction & Substance Use
In-person in Rochester, NY, and online throughout New York, Massachusetts, and Rhode Island.
Substance use often does something for us before it ultimately cost us something more.
You might look like you are living your best life. You are successful. Your marriage looks happy from the outside. But you are just trying to function. What once gave you an edge may be the sword you’re falling on.
You may find yourself:
Use to take the edge off stress, pressure, constant responsibility, or just to function.
Have accomplished a lot in your life through discipline and willpower, but find that willpower doesn't seem to work here.
Rely on alcohol or substances to finally turn your brain off after a demanding day.
Use to take the edge off stress, pressure, or constant responsibility.
Drinking or using more often than you intended
Struggling to cut back even when you've tried
Want to understand why you keep reaching for it rather than simply being told to stop.
Feel like you are performing well on the outside while struggling privately.
Feeling shame or guilt about your use
Experiencing conflict with a partner, family member, or friends because of substances
Using more heavily during periods of stress, loneliness, or emotional overwhelm
Wondering whether your relationship with substances has become a problem
Trying to change your use without wanting an all-or-nothing approach
Recovering from a period of heavier use and wanting support as you build something different
You keep telling yourself it isn't “that bad” because you're still functioning but your relationships are falling apart.
You know how to be disciplined. You just can't seem to discipline your way out of this.
You are successful in most areas of your life, but this is the one area that feels harder to control.
You can manage an impossible workload, meet everyone's expectations, and still find yourself struggling to change your relationship with substances.
If you find yourself somewhere on this list, it doesn’t mean you’ve failed, lost control, or become someone you don’t recognize. It may simply mean that something that once helped you cope, perform, or get through has stopped working the way it used to. You may not be ready to call it a problem—and you don’t have to. What matters is that you’ve noticed. That awareness can be the beginning of a different conversation, one grounded in curiosity rather than judgment and focused on understanding what’s showing up for you.
The Relationship Matters too
Addiction and substance use rarely affects only the person using substances. As a partner, you may find yourself carrying questions you don't know how to answer, conversations you don't know how to have, and responsibilities you never expected to take on.
You may be caught between wanting to support the person you love and feeling exhausted, angry, hurt, or afraid. You may find yourself monitoring, managing, covering, rescuing, or denying it has gotten so unmanageable. You might be constantly wondering what version of your partner you'll come home to. You may lose sight of where their struggle ends and your responsibility begins.
You may find yourself...
Constantly wondering how much they are using or whether they are telling you the truth.
Walking on eggshells to avoid conflict.
Feeling like you have to be the responsible one all the time.
Setting boundaries and then struggling to hold them.
Feeling guilty when you prioritize your own needs.
Questioning whether you are being supportive or enabling.
Feeling angry, hurt, betrayed, or deeply disappointed.
Losing trust and not knowing how—or whether—to rebuild it.
Feeling responsible for keeping the peace, managing the consequences, or protecting other people.
Wondering where your responsibility ends and theirs begins.
Feeling torn between compassion for what your partner is struggling with and anger about how their choices affect you.
Wondering if you can stay in the relationship if nothing changes.
Knowing something needs to change, but not knowing what that change needs to look like.
Realizing that you need support, too—even if your partner isn't ready to seek help.
You can love someone and still be deeply affected by their substance use. Therapy can be a place to make sense of what you're experiencing, strengthen your boundaries, reconnect with yourself, and get clearer about what you need from the relationship.
You don’t have to figure this out alone. Feel free to reach out by filling out the form below or connect with me here.
What Work Together Can Look Like
I’m worried about privacy and confidentially?
My office is a private space to be honest. Many individuals who come to try to get help when they are struggling or wanting to make a change worry about how this might impact them professionally. I take this seriously as a therapist. Sometimes in order to be honest about the things that are happening in our lives, building trust and co-created safety is important. This can be a space where you don’t have to perform. You can simply show up as a human and get the therapy you deserve.
Will you force me to go to detox or rehab?
No, I don’t police people in terms of their recovery or use. We explore what is going to work for you in the moment and what supports you may need. I understand too how going to detox/rehab may impact you professionally. You are coming to a confidential and judgement free space.
Will you tell me to leave my partner?
I’m not interested in telling people how to live their life or their relationships. I am interested in helping you look at what’s possible in your relationships. Dating or being married to an individual struggling with addiction/substance use is often nuanced and layered. You might be struggling with how to set boundaries, if you can set boundaries, or worrying if you are abandoning your partner when they are struggle.
What if I can’t stop?
We will take this day by day, minute to minute. I don’t have an expectation of abstinence, nor will I police you about this. We can explore symptoms, cravings, and the supports you actually are needing in the moment. I’ll hold you compassionately and directly accountable for the work you want to do.
What if I need more help and worried about my work finding out?
As part of the therapy process we evaluate together what supports you might need. I can connect with you other providers that respect and maintain your privacy. This are professionals I have worked with and trust.
What approaches do you use?
I take a harm reduction approach to the work. I have sat with many people in their most desperate moments and most severe moments of addiction and substance use. If you want to learn more about what I am clinically bringing to the table you can explore more here.
Will my diagnosis be attached to my medical record and where will this be shared?
If you utilize superbills to receive reimbursement from your insurance then a diagnosis is required. However, a diagnosis is always explored and discussed with you. To learn more about the superbill process you can explore more here.
Let’s Work Together
Sarah Nunes, LCSW
Relationship & Trauma Therapist
EMDR Certified Therapist and EMDRIA Approved Consultant in Training™