In Epidemics, Hippocrates said, “Make a habit of two things–to help, or at least to do no harm.” How can we apply that idea to helping family and friends with addictions?
When we care about individuals who are trying to overcome addictions, we often face dilemmas in how best to help them. For instance, if I help someone by providing money for some critical need, am I supporting recovery by preventing some degree of “disaster”? Or am I just shielding the person from negative consequences that might motivate lasting behavior change? The latter, of course, is AKA the E word: Enabling. This article will identify some things to consider when you face that kind of decision.
What is support? I suggest that support, at its root, consists of two things: paying attention and active helping. I could pay attention to a friend who wants to quit smoking by listening to her talk about her cravings to smoke and how she copes with these cravings. I could actively help her by informing her of new tobacco cessation products (if she was unfamiliar with them). I could take her to a SMART Recovery® meeting (especially if she felt awkward going alone), or spend a non-smoking evening with her (when her other options were to be alone or be with smokers).
How does support differ from enabling? One aspect of support–paying attention– is unlikely to shield someone from negative consequences. I probably am not making matters worse by complimenting successes or joining in celebrating them. It’s unlikely to cause harm if I take time to brainstorm alternative activities, take time to listen about stresses, express confidence in future success, or just listen to the ups and downs of the process of change.
Because paying attention is unlikely to harm, I encourage significant others, even if they are ready to cut off other forms of helping, to continue paying attention: “Son, your mom and I are drawing a line. We have provided money for bail, for attorneys, for treatment, for rent, for food, on and on. We have decided to stop, because we honestly don’t think it is really helping. We help you out of a crisis, but as soon as you are out of it, you go back to using. We think you have major addiction problems, but it’s up to you to decide how to live. We think maybe you need to get yourself out of your crises, that maybe that’s what’s needed to persuade you to change. But we are not ending our relationship with you. We still want to see you and talk with you, every day if you want. We hope you will see that we still love you deeply, and we hope our love will help. But you are going to need to solve your own problems from now on.” Note that although this statement may contain elements of “preaching, complaining, criticizing, and nagging,” they are not prominent. The addiction is discussed directly, but not judgmentally.
If we distinguish between paying attention and active helping, it becomes possible to maintain some type of relationship with the addicted individual, to the extent that both parties will make time for it. It is not necessary for a family to tear itself apart over an addiction issue, although this often happens. It is important for the family to make an early distinction between paying attention and active helping, before painful feelings build up. Even though the addiction may continue for awhile, the presence of valued relationships may be the key element of a later cost-benefit analysis, when the individual decides that these relationships are actually more valuable than getting high. If the relationships are not present, the individual is another step closer to the suicidal types of addictive behavior that arise when there is “nothing left to lose.”
Paying attention is unlikely to cause harm, but active help could either support or enable. It depends completely on the specific situation and the actual intentions of the recovering person. Intentions are difficult to judge, so we need to assess behavior. If I knew for sure that my loved one was finally on the road to recovery, then I would do a lot to help make that journey smoother and to prevent old problems from affecting the present. For instance, I might pay off a drug debt to stop the dealer from “collecting,” and consider that payment a loan payable at some later date. The problem is that we don’t know until much later how firmly someone was on the road to recovery.
When you can help wholeheartedly, I suggest you do so. We are in relationships to give and receive. A friend in need is a friend indeed. There are two times to consider being wholehearted about giving: (1) early in an addictive problem, after the first crisis or two, before someone has established a history of twisting help into enabling, and (2) well into a recovery process, when it is clear that even without you the person is likely to continue to improve.
Aside from these two times, we typically need to be cautious about actively helping, but not about simply paying attention. I suggest a few simple guidelines. If you provide money, pay the bill or debt directly, not by providing cash (you might be amazed how often this suggestion is ignored!). Remember, it’s often easy to tell the difference between helping and enabling. Provide a little help, and observe the effect. If it goes well, consider another small helping step. Don’t help so much that it jeopardizes yourself, because your help may be of no use and then you will both be in bad shape (don’t spend money you don’t have). Take care of yourself (and watch out for your addictions). Someday the person you love may be ready to meet you halfway, and it would be good for you to be ready, too.
By A. Thomas Horvath, Ph.D.
Previously published on the SMART Recovery blog on October 28, 2014.
SMART Recovery provides support for Family & Friends:
Online Meetings: SMART Recovery provides a designated message board forum and weekly online meetings for Family & Friends for tool training and peer support.
Face-to-Face Meetings: The number of face-to-face meetings for Family & Friends is growing! Our website has a current list of meetings and new meetings are being added every month.
Materials: A SMART Recovery Handbook for Family & Friends is available through our online bookstore.
For more information, please visit SMART Recovery Family & Friends.
Hello- I am new to SMART recovery and in the past had problems logging into the website. I want to be able to access the blogs and on-line meetings. I am a recovering gambler and in treatment but find GA is not really my cup if tea! Can you help? THanks!
Please let me know what issues you are having logging into SR website, it is a great resource.
I am glad you found Smart Recovery online resource is all new so I believe you will like it and find it helpful. You might check for face to face meetings close to you you might want to check out. First we need to get you on the site.
I am also new to Smart Recovery. I am particularly interested in how the on line components work.
I look forward to further training.
Robert
An excellent point is pay bills directly. I always pay my daughter’s therapist and psychiatrist directly! Everything else is ranked: Amazon Fresh for food being next, car repairs third. She is three years sober and back in school with limited income . . .
Another suggestion you can try is setting up a small expense account online for her so she can slowly start to manage her own income. 🙂 Keep up the Great Work!
Valid comments
my son has just emerged from a 6 week treatment centre. Apart from coping with the many temptations around him, what are we likely to see in him.
He seems very introspective, deflated right now after the first few days. Is this mainly facing the real world and its complications? he was quite immersed in the AA 12 point system.
Any ideas or suggestions would be great.
Kathleen, have you found our Family & Friends program on our website? https://www.smartrecovery.org/family/
We have local F&F meetings around the country, online meetings, a handbook for F&F and an interactive message board to help you connect with other parents.
You might also want to check drugfree.org. They have a terrific Parent Hotline that you might find very helpful.
I understand this can be a very confusing and upsetting time. Just remind yourself that you and him are both doing a great job!
This is a great article to provide families directly who are struggling with a loved one’s use choices. Very clearly and well written!
Agreed! If anyone is looking for more support, please visit https://www.smartrecovery.org/family/
We have local F&F meetings around the country, online meetings, a handbook for F&F and an interactive message board to help you connect with other parents.
Great article and reminder to family and or friends who have loved ones struggling with substance and behavioural addiction. Thanks for sharing.
This helps me to better explain the difference when I am asked this from Family and Friends I work with ! Thanks
This is a great article that helps to differentiate the most viable role to take when helping a loved one in need.
I do like the message in this article. All too often helping an addict goes south but support can be so helpful.
One of the first things I hear from an addict when someone wants to help is an issue about a money problem. It’s convincing because we often think most of our problems boil down to money. But it’s also often the one and only thing standing in the way of getting high.
“If I don’t give it to them it means I don’t trust them. If I don’t trust them it means I don’t love them, or I don’t care.” and/or “I owe them for the trauma that lead them to this.”
Thought provoking article.
My husband and I are both very excited about SMART recovery. At last we have found a support system that speaks to our needs. We love the tools and find the self recovery approach refreshing. My husband is finding success with his sobriety and I find support with family and friends.
We have a family night at the hospital I am associated with. I look forward to bringing this curriculum into the mix.
While I really like the body of the article, I think it would be wise to edit the “addict” terminology and replace it by “the person addicted” just because the loved one whom we talked about in the article suddenly becomes and addict and that, in my humble opinion, creates a distance and kills the loving part of the process.
Language is so important in the SMART program that we should be extremely cautious with the words used to TEACH people how to address addictive behaviors of loved ones and in a larger perspective of all folks who suffer from addictive behaviors.
Labels, guilt and shame kill people as efficiently as addictive behaviors and we are about recovery and life.
You get my point.
Several states and organizations have been using “Stop the Stigma” campaigns in order to establish better rapport with those having a “Substance Use Disorder.” I believe that we need to remove the stigma associated with any type of addictive behaviors. This has become a roadblock for many seeking recovery in the past. In SMART Recovery, people are urged to not use “labels” when describing their substance use disorder. Maybe this will encourage more people who are seeking recovery to participate in a recovery program.
I find It important to be supportive in a way that does not jeopardize yourself. I found it informative to discuss how to help others without enabling.
I think it’s very important not just to have meetings for the substance abusers, but for the family and friends as well. Not only are they going through hard times too. But this article alone explains a great deal of it. They don’t know how to be there without giving something that will only continue the use. This is a great point.
Thank you for this article – it helped a lot and provides some language I have been struggling to come up with on my own.
I have been enabling my son for about 16 months. My fear was that he would alienate me. This week, his drug habit became exposed (publicly) through social media. I am sure he is embarrassed and felt obligated to speak to us on his own behalf. Through text messages, my son let me know how long he has been using, what type, along with a strong desire to stop. I am also keenly aware that he will need financial help for food and his electric bill soon.
Since he has experienced this public “outing” and desire to stop, would it be reasonable to consider this the early stages (or first crisis) of his addiction and provide some financial help (buy his food directly, pay his bill). Would it also be appropriate to let him know we are moving foward if we see signs of continued use/harm? May main goal is to let my son know I am here for him and believe in him, but I am no longer willing to ignore signs of drug use/purchases.
I should note, he still uses his teen checking account so we are able to monitor his spending and question where his money may be going.
Thank you for any advice or guidance.
Thanks for reaching out! You can find great information and Family & Friends meeting listings on the Family & Friends page at http://www.smartrecovery.org/family. Our skills training for Family & Friends includes tools for positive communication skills and other strategies to help you change the dynamics of your relationship with your loved one. This method has been proven to be more successful than harsh interventions or complete detachment.
Our mutual desire is that your loved one will take on the choice to pursue their own recovery and that you will learn ways of improving your life at the same time.