Alcohol dependence not only affects the client but can have a devastating impact on the drinker's family as well. The reactions and attitudes of family members toward the drinker, especially those of spouses of alcoholics who may have endured their partner's problem drinking for many years, are often understandably negative and may hamper recovery efforts. This article describes some of the relationship dynamics common to couples struggling with one partner's alcoholism, and seeks to provide a better understanding of spousal manifestations of expressed emotion. Treatment strategies aimed at reducing high levels of expressed emotion in hopes of preventing drinker relapse are also discussed in the context of couples therapy. © 1998 John Wiley & Sons, Inc.