Tough Love – Harmful or Helpful?

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.

For some family members, it's difficult to forgive and forget a loved one - even after years of sobriety.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.

Tough Love - Harmful or Helpful?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.

Lisa Frederiksen

Lisa Frederiksen

Author | Speaker | Consultant | Founder at BreakingTheCycles.com
Lisa is the author of hundreds of articles and 11 books, including "If You Loved Me, You'd Stop!," "Addiction Recovery: What Helps, What Doesn't," and "Secondhand Drinking: the Phenomenon That Affects Millions." She is a national keynote speaker with over 25 years speaking experience, consultant, and founder of BreakingTheCycles.com. She has spent more than 14 years studying 21st century brain research in order to write, speak, and consult on substance use disorders prevention, intervention and treatment; mental disorders; addiction (aka substance use disorders) as a brain disease; adolescent addiction treatment vs adult addiction treatment; effective treatment for co-occurring disorders (having both a substance use and mental disorder); secondhand drinking | drugging; help for the family; and related subjects. In 2015, she founded SHD Prevention, providing training and consulting to companies, public agencies, unions, nonprofits and other entities to address the workplace impacts of employee secondhand drinking and alcohol misuse.

16 Responses to Tough Love – Harmful or Helpful?

  1. 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

    • Jacqueline says:

      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.

        • Jacqueline says:

          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.

    • n says:

      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.

  2. Jacqueline says:

    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.

  3. 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..

  4. 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.

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