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He says she smokes pot every day and it's a problem. She says he never talks to her and their sex life is nonexistent. Can this marriage be saved?

The Couple

Teri: 49, executive director of a large nonprofit
Sean: 42, landscaping contractor
Married: 19 years
Kids: None

The Counselor

Judith Landau, MD, Boulder, Colorado

The Background

Teri coped with job stress and marital frustration by smoking a lot of pot — and picking fights. Sean hated her drug use and criticism but rarely said so. When Teri suddenly had to have brain surgery, it was a wake-up call for both of them.

Sean: I'm really worried about Teri. Her brain tumor was benign and operable, thank God, but her health has gone downhill since the surgery — she's lost 25 pounds. When they found the tumor, it was a crucial time for her organization and Teri felt she couldn't take much sick leave. She was scared she'd lose her job and health insurance. I get that, and it's been an incredibly stressful six months, but health has got to come first. I try to encourage her to eat, but we just end up fighting. And I know she has reason to be depressed, but smoking pot till she's a zombie isn't the answer. Teri seems to think she's using marijuana medicinally, but I think it's the opposite: Getting high makes her more depressed and so spaced out that she forgets to eat. Teri's only a few years younger than her mom was when she died of alcoholism-related health problems. It scares the hell out of both of us.

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Teri: It's true that my health issues — and smoking marijuana is definitely one of them — finally motivated us to seek help. But we're not here just because of pot, and if Sean wants things to change he needs to stop referring to me as a zombie and start working on our relationship. We've been going through the motions for years. I can't get Sean to talk about anything, and that makes me start yelling, just to get a reaction! Our sex life is nonexistent. And now we're also dealing with my recovery from the surgery. It's harder for me to process information right now and my emotions are all over the place. The doctor told me to expect that, but I get so down about it all that sometimes life feels like it's not worth living. Marijuana isn't what makes me feel that way; it's what helps me survive my depression.

Still, the tumor made me realize I have to take better care of myself, which probably includes not smoking pot. My mom was a blackout drinker and I used to drink a lot myself, but I've stopped that now. I sure don't want to end up like my mom, so I'm willing to look at the idea of quitting, but I don't think that pot is our biggest issue. Bottom line, I can't take another 20 years of what Sean and I are doing. I'm over it. I want a sex life.

Sean: I'll admit I'm not as much of a talker as Teri is, but I'm here, aren't I? And speaking of talk: Teri goes on and on about quitting pot, but it never happens. I don't think she takes her family history anywhere near seriously enough. Or her high-profile job, for that matter — she has rivals who would go after her in a minute if they knew she was a pothead. The press would love it. I'm surprised she hasn't gotten busted already. Teri thinks no one knows she smokes weed, but people have confided in me that they've seen her high in public. I was willing to overlook the pot-smoking earlier in our marriage, but I'm starting to think it's behind some of our other problems.

And Teri may think she's using it to cope with her depression, but the truth is, she was getting high on a daily basis long before she had the tumor.

As for our sex life, I want one, too! It infuriates me that Teri makes it sound like it's my fault, when she's the one who pushed me away sexually early on in our marriage. And now she complains that I need to make more of an effort to connect, but she's so zoned out on pot I can't reach her.

Teri: How is my zoning out by getting high any different than his zoning out in front of the TV every single night? I'm sorry, but watching Dangerous Jobs together is not connecting. It might feel like it to Sean, but not to me.

I understand that TV is how he relaxes after work, but I'm not interested. We try playing cards or games, but Sean insists that the TV stay on. I beg him to suggest something new for us to do, anything but the same old thing, but he can't seem to do it.

Sean's right about sex, though — the fault lies with both of us, but I'll admit that at first the problem was mostly me. Our sex life basically ended the day Sean asked me to marry him. I was sexually abused by my older brother's friends — people I trusted — starting in third or fourth grade. As a reaction, I became suspicious of anyone I was close to. The more emotionally intimate I became with a man, the more likely I'd be to shut down sexually or flash back to bad experiences. Ironically, the closeness and commitment of marriage made it impossible for me to trust Sean. It ruined sex for us. That was years ago and nothing's changed; we've never really tried fixing things. And I'm at the point where it's driving me crazy.

Sean: Teri says she wants to connect with me and have this wonderful sex life, but she's constantly belittling me. I can't even wash the dishes or walk the dog without some outburst from her about how I did it wrong. I tend not to respond when she puts me down, but does she really think it doesn't affect me? Of course it does. I take it all in, and it hurts. It makes me feel like less of a man. How is that supposed to improve our sex life? Sex is important to me, too, but I've always thought enjoying each other's company, being good travel companions — the things that, to me, were working in our marriage — helped make up for the lack of sex. But don't think I haven't been frustrated about it.

Teri: Sean's never said this before. I know the problems in our marriage aren't all his fault, and I feel bad hearing him say how hurt he feels. But if I'm going to give up pot, the one thing that helps me get through the day, we've got to replace it with something — activities, new adventures, having fun together. It can't just be the two of us sitting in front of the TV. I want that romantic love that I know we're capable of. If we're going to continue with our relationship on autopilot, I'd just as soon be stoned.

The Counselor: Teri and Sean were both ready to call it quits when they initially met with me. Yet despite his frustrations, Sean loved Teri and was afraid of losing her. Teri felt the same way, though she badly wanted renewed passion in their marriage and the sex life they'd never had. She understood getting high wasn't helping with that.

Indeed, Teri's substance abuse wasn't responsible for all of her and Sean's troubles, but addressing it was essential for their relationship and, quite possibly, her survival. Teri's declining health was typical of an addict: Substance abusers are notoriously bad about taking care of themselves. It's a kind of slow suicide. At the same time, I knew Teri's success at overcoming her addiction depended on whether she could address a number of other issues, including her relationship with Sean.

Teri talked nonstop during our early sessions; Sean, almost never. Frustrated with his inability to speak his mind, Teri was prone to verbal tirades. Sean would try to placate her or, more often than not, he would simply stop talking.

Job one for the couple was improving communication. Sean had to learn how to talk about his feelings and Teri needed to learn how to listen. I showed them an exercise that allowed each of them equal time to talk and listen. I also coached them on the technique of sticking to their own feelings when discussing a conflict — "when you do x, I feel y" — rather than blaming the other. And after the first few sessions, I consulted with Teri's primary care physician about medication. He prescribed an antidepressant, which helped her gain a bit more control over her emotions.

The couple's communication got a lot better. Sean talked about things he'd never been able to, like how Teri's cutting words made him feel emasculated. Teri began seeing Sean in a new light and felt better understood by him. Being able to talk through conflicts without worrying that the other person would retreat into silence or fly off the handle was a huge step.

Next, we tackled Teri and Sean's sexual problems. They were deeply entrenched, and complicated by Teri's history of sexual abuse. It's common for survivors to be incapable of intimacy with their life partners. And it was no accident that Teri married a kind man who wouldn't fight back or injure her, even though this passivity ended up being a source of frustration to her.

Meanwhile, Sean felt rejected by Teri early on, then, later, her constant criticism ate away at his self-esteem. Since their problems were so long-standing, we agreed that they would try sex therapy. The term makes some clients nervous, but it simply means undergoing talk therapy with someone specially trained to help with sexual problems.

In the meantime, we explored their marriage goals and worked on constructive ways to deal with the sore spots. For example, to break the negative cycle surrounding Sean's attempts to get Teri to eat, I asked them to plan one meal at a time, working together on the menu. Sean agreed to prepare meals, then simply leave them in the fridge without nagging Teri, who agreed to eat — on her own schedule.

I also helped them understand addiction and its causes. Sean, as a hurt and angry spouse, needed to see that substance abuse isn't about being weak. We made a detailed history of Teri's addiction and looked at how her dysfunctional family and the sexual abuse she suffered as a child contributed to it.

Teri definitely needed to take her substance-abuse problem seriously, and I encouraged her to attend a 12-step program, reassuring her that the meetings were confidential. When she still worried about public exposure and losing her position in the community, I gave her a web link to anonymous online meetings. So far she's refused my efforts.

To Teri's credit, however, she's cut back greatly on smoking marijuana, stopping completely for long stretches. "I hope I get to where I never feel I need pot again," she says. "I'd much rather find satisfaction with Sean." And she and Sean are indeed doing much better. He's made huge strides in communicating. "Getting professional help made all the difference," he says. "It's helped me step up, rather than clam up or walk away, when Teri needs me to be present." Though they've yet to achieve all their relationship goals, after years of physical and emotional estrangement, Teri and Sean are cuddling again and making plans to pursue sex therapy.