Tough Love – Harmful or Helpful?
Tough love – does it hurt or help a person with an addiction to alcohol or other drugs, aka substance use disorder (SUD), get the help they need?
I regularly get some form of this question – generally because there’s so much confusion about what it means. Unfortunately, there is no single definition of tough love applicable to addiction.
Some experts believe tough love means to cut off all support and contact in order to help a loved one hit their bottom and thus seek help. Others believe there is some middle ground, such as paying their rent or car payment so they have housing and transportation to and from a job (when they get one). And still others believe it’s staying in contact, expressing your love and support and willingness to help when your loved one reaches out for help with seeking treatment.
For a majority of family members, some or all of these approaches are tried at one time or another. And for some, there’s no other answer than, “I’ll do anything I can because not to could mean they’ll get worse, or worse, yet, they’ll die.”
To help those with whom I work as a family addiction education consultant and/or recovery coach, I ask the following questions, and in our work together, we answer them. I say, “in our work together,” because there is no one nor right way to support or help a loved one with addiction, aka substance use disorder, but there are some common road blocks to success no matter where a person falls on the “tough love” continuum.
What do you think addiction is?
Answers vary from poor choices, lack of willpower, it’s a disease (but I don’t see why it’s considered a disease), to name a few.
The “correct” answer is, “Addiction is a developmental, chronic, often relapsing brain disease.” Whew! That’s a mouthful, I know, but it’s a complicated disease, as are most chronic diseases, for you see, disease, by it’s simplest definition is something that changes cells in a negative way. When you change cells in a body organ, you change the health and functioning of that organ. Addiction changes cells in the brain — the organ that controls everything a person thinks, feels, says, and does. Check out the National Institute on Drug Abuse (NIDA) > “The Science of Drug Abuse and Addiction: The Basics.”
Does your loved one have any of the five key risk factors for developing addiction?
These risk factors influence how a person’s brain develops — in other words, how their brain cells talk to one another and map repeatedly used neural networks as their “go-to” thoughts, feelings and behaviors. These are important concepts to understand because addiction is a developmental brain disease. The key risk factors include:
- genetics (are there persons in the immediate or extended family with addiction (substance use disorder?)
- early use (did they misuse the substance(s) during adolescence and/or early adulthood?)
- childhood trauma, aka ACEs — adverse childhood experiences — (did the person experience verbal, physical, emotional abuse; neglect; parental divorce; parental substance misuse?)
- mental illness (does the person have bipolar, depression, anxiety, or ADHD, as examples?)
- social environment (what was the home/social environment like; how were substances used by others in the family?)
Understanding these helps a person appreciate that treating/changing the treatable risk factors (e.g., childhood trauma, mental illness, social environment) is critical to relapse prevention and success in long-term recovery.
Do you understand the characteristics of addiction – what makes it addiction vs substance abuse?
The four key characteristics of addiction include: tolerance, loss of control, cravings, and physical dependence. Understanding these helps a person appreciate why anti-craving medications, behavioral modification therapy, and medically supervised detox may be necessary to successfully treat addiction.
Are you familiar with the concept of “setting boundaries?”
You’ll likely have heard this expression and perhaps told you need to set better boundaries. If you’re not familiar with it or are having trouble setting boundaries with your loved one, check out my post, “Setting Boundaries YOU Can Live With.”
Are you aware of the many methods of effective addiction treatment?
In other words — there is no one size fits all. For more on this, check out NIDA’s Principles of Effective Treatment.
For more information on the above and other related concepts…
…consider my Quick Guide to Addiction Recovery: What Helps, What Doesn’t.
No one can answer the tough love question – “Is it helpful or harmful?” – for you, but answering these kinds of questions is a start towards answering the question for yourself. Additionally, critical to helping you answer this question is recognizing how deeply you’ve been affected and appreciating that you need support and help, as well. Unfortunately, to address what that might look like is beyond the scope of this blog post.
Always feel free to contact me at 650-362-3026 (PST). There is no charge for the initial call.
©2017 Lisa Frederiksen
Lisa Frederiksen
Latest posts by Lisa Frederiksen (see all)
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I have 2 sons who are heroin addicts. My journey is not as difficult as theirs must be. But as a parent it has been very very tough at times. I continue to attend my ALANON support groups. It would have been impossible to move on with my own life otherwise. My boys and I always seem to be navigating new waters. It is never easy. But with love and support – and hopefully not too much enabling, some tough love thrown in there as well – my sons will see this through and accept their chronic disease as one they should work on every day. I so appreciate and learn from all of Lisa’s insight and support in dealing with this chronic relapsing brain disease. My hope is that more people take the time to learn about addiction. And the fact that those battling it cannot just stop. If only it could be that easy!
Thank you so much for sharing your experiences, Jean, and for your compliment of my work. Wishing you and your sons all the best…Lisa
It is so hard Jean I attended Alanon x 1 year, perhaps I need to return. We are fortunate to have articles like Breaking the cycles available also. Take care.
Perhaps ALANON will help you through some of those difficult times. I do am sooooo grateful for all of Lisa’s articles and insight. It is important to know we are not alone in tbis journey. I will remember you in my prayers Jacqueline.
Thank you Jean. As I will remember you in mine. It is such a lonely disease, not everyone wants to learn about it. Just think a person can stop. Not true. We all wish it was that way.
Yes, they can just stop-it’s a matter of support and how much benefit versus cost to stop. meaning-if a gun was put to his/her head or a bust was going down, a court date approaching, said person could stop. It’s a matter of what the cost is to the person to stop. For many, the cost doesn’t outweigh the benefit of using (in the addicts mind frame). Yes, an addict can stop, but he/she needs support. If he/she couldn’t, then rehab, cognitive behavioral therapy, 12 steps, etc. wouldn’t be of any benefit and the recovery rate of addicts would be 0%. It sounds to me like you are giving your sons a pass for their addictive choice. Yes, it is a choice. It’s a disease of choice.
I guess we can agree to disagree. I do not believe addiction is a disease of choice. My sons did not CHOOSE to have a chronic relapsing brain disease. Just as someone does not choose Alzheimers or Parkinson’s disease or cancer. So much has been altered in their brains. Their CHOICE whether to stay in recovery is theirs and theirs alone. But they did not CHOOSE to have this disease to begin with. I appreciate your input. Thank you.
I always appreciate articles you write that encourage me to reevaluate where I am at coping with my son’s addiction. I can never get enough education about this disease. I also share this information with friends who are in the same situation as myself. I forward to my son also, never sure if he reads the articles though. Very hard to cut a child regardless of their age out of your life completely. Hard brain disease, but yes if it was cancer, we would all be there in a heartbeat. Offering support, researching, caregiving as necessary.. Thank you Lisa.
You are so welcome, Jacqueline, and thank you for sharing your experiences and support of my work.
Lisa
Can I print an article and give it to a counselor I have started to see?
Not too sure if this counselor is a good fit for me.
Thanks
Absolutely – thanks for asking – feel free to share anything I post.
I am a facilitator of a Parent support Group (A-TAP, Anacortes-The Addict’s Parent). I wonder if we could get this brief and clear article to hand out at a meeting? We struggle with the disease issue as well as boundaries. We realize that there are no certain rules in place for that, but maybe parents would look into your writings more if they saw this..
You’re welcome to print copies and hand them out – I’m so glad you find it helpful.
Hi Beth We have nothing like your support group in the city I live in. We have AA Al Anon and NA. Plus private counseling if you can afford it. Can you share more info on your group with me? Thanks
Lisa
Thanks for raising the question.
The term “love” has caused many things! Marriage and war! I am not sure what the word means and our best poets and artists all want to create definitive examples. Perhaps that’s all we’ve got?
Striking off what love is not, is a painful AND enlightening experience.
Hafiz puts it nicely:
Love sometimes gets tired of speaking sweetly
And wants to rip to shreds
All your erroneous notions of truth
That make you fight within yourself, dear one,
And with others,
Causing the world to weep
On too many fine days.
God wants to manhandle us,
Lock us inside of a tiny room with Himself
And practice His drop-kick.
The Beloved sometimes wants
To do us a great favour:
Hold us upside down
And shake all the nonsense out.
But when we hear
He is in such a “playful drunken mood”
Most everyone I know
Quickly packs their bags and hightails it
Out of town.
Thanks once again, nice read.
I agree – wonderful description by Hafiz. Thanks so much for sharing and taking the time to comment.
This is such a great article – I am a recovered addict of 16 years and when I was struggling and eventually entered long term residential treatment, I was the sole person at both facilities that had not even one solitary family member show up for the family portion of their programs. My recovery, I believe, was made much more diffucult with no family support whatsoever but I am so thankful I did not let that prevent me from fighting and working hard to rebuild my life free of addiction. So when a good friend of mine recently shared with me that her adult son has become seriously addicted to drugs, I promptly uurged her to immediately begin attending support groups such as Alanon and told her that knowing how little I knew about addiction when I found myself in the middle of it, that it stood to reason that most people simply know very little about the subject and it is impossible to be successful at dealing with such a complex and tricky thing as addiction without education and support and hard work. I offered that I would be happy to go to a meeting or meetings with her if she would find that helpful. Alas, she evidently has elected to wing it and make it up as she goes in dealing with her son’s addiction. I find that maybe sadder than having no family support – to have a loving mother yet one who is not willing to go to any real trouble or effort in dealing wirh this incredibly serious problem. I sent her a link to this article – while I know I am powerless to get her to change her approach – I did not feel it was over-stepping to simply send link in hopes she would read it and gain some understanding of what she is dealing with. I know from experience it is natural for people to want a fast, easy fix but with addiction there simply is not a fast, easy fix. It is brutally hard work but is so worth it to be able to gain the tools and the knowledge and the skills it takes to completely change your life and become a happy, healthy drug free person. I will continue to wish for my friend and her son and everyone that addiction has overtaken their life to be awakened and have the clarity and moment of truth to simply say “I have no idea what I’m doing but I know it’s not working” and then say and mean the three hardest words there are for most people to say, “I need help.” May all beings be well, be happy and love and be loved.
Billie – first of all – congratulations on your 16 years recovery!
Thank you for your thoughtful post and for the work you’re doing to help others understand all of this. I wrote my “10th Anniversary Edition If You Loved Me, You’d Stop” to address issues like those you raise in your comment.
If you would like to share your experience, strength and hope in a guest post or as a Face of Recovery on BreakingTheCycles.com, please send me an email at lisaf@BreakingTheCycles.com.
Again, thank you for your comment, Lisa