Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states
Does someone you love abuse drugs and alcohol? Are you at the point where you are filled with despair and worry about this person? Are you unwittingly helping this loved one remain addicted? If the answer to all of these questions is yes, then you are engaged in codependent and enabling behavior:
Fictional E. Mail Inquiry:
In this fictional E. Mail a parent writes to Dr. Schwartz about the following dilemma:
I am the mother of a thirty year old son who is abusing drugs and alcohol. He has been hospitalized and detoxed once and has been through an excellent drug rehab program. However, he quickly relapsed and is again abusing drugs. He has lost his job and is now living with us. What can we do to help him? We love him very much and want to be of help. In a family meeting at the rehab program they advised us to go to ALANON meetings and learn how to cope with this. They also advised that we not give him money and not allow him to live at our home. But, we do not want him in the streets, we love him, want to help him get better and we worry that something bad could happen if we did not give him money now that he has lost his job. Is there some medication that could cure him? Worried Parent
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While this E. Mail is fictional it contains the very same details that a myriad number of families go through each day. What the E. Mail brings to mind is the vague and difficult to understand concept of Codependence and Enabling. Let discuss it and see what it means.
Definitions from National Institute on Drug Abuse:
Codependency occurs when another individual, perhaps the addict’s spouse or family member, is controlled by the addict’s addictive behavior. Codependents become codependent because they have learned to believe that love, acceptance, security, and approval are contingent upon taking care of the addict in the way the addict wishes. In their decision-making process, they allow the addict to define reality. Unfortunately, this excessively care giving behavior tends to foster even more dependency on the part of the addict.
Enabling behavior occurs when another person, often a codependent, helps or encourages the addict to continue using drugs, either directly or indirectly. Examples of individuals involved in enabling behavior are a spouse hiding the addict’s disease from neighbors or their children by lying for the addict and a so-called "friend" giving the addict money to buy drugs.
In the fictional E. Mail above the parents of the addicted person are codependent because they are protecting him from the consequences of his behavior. By doing so he is unable to learn where the addiction can take him. He has not had to face life in the streets or the loss of his family. Of course, this man is loved by his parents as most people would expect. In addition, they do not want to lose him to disease, homelessness and, possibly, death. The irony is their love and behavior towards him could lead to those very consequences. Also, they do not want him to be angry at them and would do anything to prevent that. It is not only that they cannot withdraw their love for him but fear the loss of his love for them. Therefore, they protect and nurture him as well as his drug addiction. This is codependence.
It is a well know fact among drug and alcohol counselors that the worst enemy of the abuser is money. The reason for this is that money becomes the means the addict makes purchases of more drugs to feed the addiction. Because the addict is a person who has learned the fine art of manipulation to get what he wants, he knows how to convince loved ones to provide the money he needs to make more drug purchased. If it means telling lies the addict has no compunctions about doing so. Enabling occurs because loved ones generously provide money to the addict in the naive hope that no lies are being told and in the hope that it will help him recover. It is amazing how family and spouses blind themselves to the facts about what is really happening.
One of the most tragic examples of enabling behavior I can think of occurred many years ago with people who were, at the time, good friends. Their adult daughter died of an overdose of Vicodin and alcohol. They had asked me for a referral for their daughter to a therapist because they believed she was depressed. When the death actually occurred I learned that depression was not the issue. Instead, the daughter had a long history of abusing opioid drugs. In actuality, she was seeing a psychiatrist for depression but the daughter and parents kept the drug and alcohol abuse a secret. When her death occurred the family was overwhelmed with shock, grief and loss. Their secrecy was a classic example of both codependence and enabling behavior. What was even more tragic is that they had no idea of what they were doing. They were in denial about her drug abuse. Denial means that they remained unaware of her using opioids even though it was happening in front of them.
What Can You Do?
1. If you have a loved one who is abusing drugs and alcohol one of the first things you can do is call either Alcoholics Anonymous or Narcotics Anonymous and find out where there are meetings for the families of abusers, and begin attending those meetings. There is not cost and you get to meet with other families who are dealing with the same problem. The purpose of the meetings is to learn form one another how to stop being codependent and how to stop enabling behavior.
2. Do not provide money or a place to live for the individual who is abusing drugs. Instead, insist that they get themselves into a drug counseling program. Many people need to go through detox before anything else. Detox is done inpatient in a drug rehab program. If necessary and necessity depends on the kind of drug the patient is addicted to, medications are used to ease the process of detox. Then, once detoxed, the patient is referred for drug rehab that can take many months of treatment. After all of this the patient should attend AA or NA meetings to prevent relapse.
3. Tough love refers to the need of the family of the addict to not give in while refusing home and board to the abuser until they get themselves into recovery. When all the codependent and enabling behavior stops it then becomes the choice of the addict to decide whether or not they want to recover from the addiction. Because of the nature of addiction, many addicts decide to continue their addictive behaviors. In that case, the family must remain tough and not give in to the addict. This means that the addict may become homeless while sleeping in shelters. In some cases they may even be arrested and end up in jail. It is essential that the family not attempt to rescue their loved one.
Many addicts are able to reach a point where they want to recover because they cannot stand to lose any more of what they formerly had. In any event, it is only when the addicted person is face to face with real consequences that they can start to make better decisions. This is something that I have witness repeated with those unfortunate people who do abuse drugs.
None of this is easy and drug abuse is heart wrenching and painful for both the family and the addict.
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