male survivor here -
for me - my wife had to say - "This is not working. You need to get professional help. Or there will be consequences."
i was so deep in denial that i didn't even recognize how screwed up i was. it was a relief to me to have a push in the right direction. once it was "out there" i knew i had to do something to save our marriage and regain my life.
i can't say that course of action will work for everyone - but it was the beginning of big steps in recovery for me and mending a broken relationship for us.
"That you are here - that life exists, and identity; that the powerful play goes on and you may contribute a verse. . . What will your verse be?" Robin Williams as John Keating in "Dead Poets Society"