Ms. B's older brother, who is married and has two children, is anxious but functions well at work and at a distance from the family. He waits for others to take charge and cooperates with them. Ms. B's younger sister is the most symptomatic sibling. She is "wild and crazy" and has alcohol and drug problems. Ms. B watched her parents take care of her younger sister and encourage the sister's dependence on the family. It is the younger sister who functions in this family more like her husband, which is something Ms. B had not seen on her own. Mr. and Ms. B met at college and began to live together in 2006. They were both pretty capable for a time. They finished college and moved to Houston where each began to work. Two things happened in their families after they become a couple. The first family event came into play in 2009. Mr. B's maternal grandmother begins to develop dementia and depends more on her children. As this happens, Mr. B's mother discovers that her oldest sister's son has been embezzling funds from the estate. Animosity and explosive confrontations occur between his mother, her older sister, and their mother over the two years until Mr. B's grandmother dies. Mr. B develops acute and debilitating hearing loss during this time. His symptoms are diagnosed as stress-related and remedied with medication. He recognizes that he was reacting to the family conflict but does not see any connection between his own family turmoil and his symptoms and functioning in the marriage. He also does not yet see relationships in his family as avenues for change.
Around the same time, six months before Mr. and Ms. B marry, her father receives a cancer diagnosis and begins to fail. The cancer progresses quickly. In the face of the diagnosis and in the aftermath of the turmoil in Mr. B's family, they marry in July of 2010. Within two weeks of marriage, Ms. B's father's cancer symptoms worsen, and Ms. B's parents briefly move in with the couple. After only a few weeks, her parents return home where her father dies in hospice care. This is a huge disruption for Ms. B's family, and Ms. B spends a lot of time traveling to be with her newly widowed mother. Although Ms. B can appreciate the impact of her father's death on the family, it is difficult for her to recognize her own reactions and how they played a part in the marital problems that occur.
After her husband's death, Ms. B's mother lives alone for a time and the younger sister is somewhat stable independently. It is interesting that Ms. B's younger sister had stabilized and moved out on her own in 2010, at about the same time the couple married and the dad's cancer accelerated to his death. She began to flounder in early 2011, resulting in her moving in with Ms. B and Mr. B for about six months in 2012. During this time, Mr. B focused on helping his sister-in-law, but his own drinking and drug use accelerated. He entered rehab in 2013 for drugs and alcohol. Ms. B's younger sister moved back with their mother and has remained there As they reviewed the history of the families, both Ms. B and Mr. B were able to begin to consider the impact on their marriage of events in each of their families. They were able to think about how the reactivity stirred for each of them related to the family, not to personality flaws or problems they encountered with each other. They sketched a basic pattern in the marriage in which Mr. B would drink more, stay out longer, and be less available after her father's death and her sister moved in. Ms. B alternated between being more critical of her husband or feeling sorry for him and taking care of him. Mr. B distanced into his own work projects and problems, which were significant. He described the marriage "shutting down for him." He "shut down" in the marriage, had no more feelings for his wife, and was not interested in intimacy, sex, or closeness with her. He started a long-distance affair on one of his work trips in April 2016. They separated for the first time in May of 2016.