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.

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

  • Using substances to manage stress, anxiety, difficult emotions, or relationships

  • 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.

  • Hiding or minimizing your substance use from people you care about

  • 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.

The Relationship Matters too

You may find yourself...

  • Constantly wondering how much they are using or whether they are telling you the truth.

  • Trying to figure out whether something is actually wrong or if you're overreacting.

  • Walking on eggshells to avoid conflict.

  • Checking, monitoring, covering for, or making excuses for your partner.

  • Taking on more responsibilities because you can't rely on them.

  • Feeling like you have to be the responsible one all the time.

  • Having the same conversation about their substance use over and over again.

  • 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.

  • Missing the person your partner seems to be when substances aren't involved.

  • Feeling lonely even when you're together.

  • Watching your partner make choices that affect you, your family, or your future together.

  • Trying harder and harder to create stability in the relationship.

  • Feeling like your relationship revolves around their substance use.

  • Losing trust and not knowing how—or whether—to rebuild it.

  • Finding yourself becoming more controlling because you don't feel safe letting go.

  • 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.

FAQs About What’s It’s Like To Work With Me

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 relationship. 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, and worrying if you are abandoning them.

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.

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.

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™