Compassion versus co-dependence.
I have often written on what many refer to as co-dependence, but it is a subject to which I find I must continually return. I do sometimes envy those individuals who seem to be able to clearly distinguish between what is co-dependence and what is compassion. I have read and reread the many books on the subject. I have attended AL anon and other similar support groups. I have talked with other therapists and trusted friends. I am sometimes able to “draw a line in the sand” with a client, friend or family member. Some of these lines are:
On the other hand, I will:
The 12 step program, tough love advocates and many helping professionals often state or suggest that many humans who are struggling with addictions or other diseases have to reach their bottom before they are able to make positive changes. What counts as a bottom for some may not be a bottom for others? One man I know who struggles with alcoholism has been in the intensive care unit of the hospital 3 times for acute pancreatitis, lost a number of jobs, lost romantic relationships and done great damage to family relationships. Despite all this, he has yet to reach his bottom if indeed he has one short of death or an acute accident which would leave him permanently differently abled or disabled. He was raised in a very loving, high functioning family. His sister is a professional woman, wife, mother and active community member. He is a very talented man trained to do many skilled jobs. He hates being the unsuccessful one of the family and, yet, cannot allow himself to quit drinking and use treatment resources to heal. His father controls his medications so that he does not abuse it. His parents help him in a lot of very practical ways and always include him in family celebrations. Yet, he continues to drink and to keep family members waiting for the next crisis. Would tough love - cutting off all assistance - help him reach his bottom? Some would say yes although even those would acknowledge there is always the possibility that he would get more self-destructive and might even actively commit suicide.
I just saw a young man who began using drugs to avoid dealing with life on what then constituted life on life terms when he was 11. He has now been clean for two years and is currently in a residential treatment program. He has been living out the script of someone who is the son of an alcoholic and who is the various diagnosis he has been given. His diagnosis includes social anxiety, depression and sleep disorder. His life has often been dictated by the truths he learns about himself and how he learned to survive. His thought process has led him on a path of weakness, hopeless and self-destruction. Is this because of the depression and the social anxiety or are the symptoms of those diagnosis a result of his belief system about himself. Some of this behavior is typical for a 19-year-old even without his particular history. He clearly needs to be treated with love and respect. Expecting him to behave as a 19-year-old adult is respectful. Expecting him to behave as an adult who is ready to take complete responsibility for his life is not loving, respectful or realistic. In some ways, he is still a very young person who thinks like a 11-year-old – the age he started using. In other ways, he is an exceptionally bright, thoughtful young man.
Guidance, parenting, and mentoring requires a careful mixture of challenge, love, understanding and an acceptance of a person’s need to discover their own truths.
With each person, it is important to set realistic, practical goals. I also remind myself to remember that what works for one may not work for another. Assigning labels such as co-dependence or tough love may not be very helpful. It is clear that change requires a certain level of discomfort. That discomfort may come from the knowledge that I am not all I want to be or can be. It may come from knowing I do not want to be in jail or do not want to love my family or my job. For others, the greatest discomfort may be confronting the fear of failing. For these individuals going to an institution may be the least uncomfortable thing that can happen.
There is much we do not know about change or how to motivate and help ourselves and others to change. If indeed tough love works with some it is because it is clear that the emphasis is on love(compassion and not on tough. My experience is that it is easy for all of us to fall into the trap of being so frustrated with the behavior of another that we take action because we are angry and not because we want to help. We may say we are practicing tough love, but in reality, we are just angry and our using our power to disengage from the person. I am not sure that this is ever helpful. Yet there might be those people who will get better just to prove one is wrong!
Treating someone as a helpless child can also be an “easy” way out for the family member or the helping professional who is exhausted from dealing with addiction or a mental illness. Co-dependence like tough love may be more about my own level of frustration and anger than about the desire to help.
The bottom line for me is to me to:
Written October 11, 2017
I have often written on what many refer to as co-dependence, but it is a subject to which I find I must continually return. I do sometimes envy those individuals who seem to be able to clearly distinguish between what is co-dependence and what is compassion. I have read and reread the many books on the subject. I have attended AL anon and other similar support groups. I have talked with other therapists and trusted friends. I am sometimes able to “draw a line in the sand” with a client, friend or family member. Some of these lines are:
- I will not allow an active addict to stay at my home although I have on occasion on a cold winter night allowed someone to spend an hour or two on my couch.
- I will not pretend that an active addict can be a friend and certainly not a romantic partner.
- I will not make a home visit to a client who is actively using and living alone.
- I will not buy a luxury item for someone although what constitutes luxury is often very subjective.
On the other hand, I will:
- Remember that the fact that my mind can allow me to make choices today which leave me financially stable and able to take care of myself is a blessing for which I can take no credit.
- Remember that no one chooses to be an active addict or to have a mental illness, both of which conditions affects how the decision-making part of the mind functions.
- Honor what appears to be the decisions others make about their health care when they do not directly affect me. This one is tricky. How does one make a healthy decision to seek or not seek treatment when one’s mind is controlled by addiction or mental illness.
The 12 step program, tough love advocates and many helping professionals often state or suggest that many humans who are struggling with addictions or other diseases have to reach their bottom before they are able to make positive changes. What counts as a bottom for some may not be a bottom for others? One man I know who struggles with alcoholism has been in the intensive care unit of the hospital 3 times for acute pancreatitis, lost a number of jobs, lost romantic relationships and done great damage to family relationships. Despite all this, he has yet to reach his bottom if indeed he has one short of death or an acute accident which would leave him permanently differently abled or disabled. He was raised in a very loving, high functioning family. His sister is a professional woman, wife, mother and active community member. He is a very talented man trained to do many skilled jobs. He hates being the unsuccessful one of the family and, yet, cannot allow himself to quit drinking and use treatment resources to heal. His father controls his medications so that he does not abuse it. His parents help him in a lot of very practical ways and always include him in family celebrations. Yet, he continues to drink and to keep family members waiting for the next crisis. Would tough love - cutting off all assistance - help him reach his bottom? Some would say yes although even those would acknowledge there is always the possibility that he would get more self-destructive and might even actively commit suicide.
I just saw a young man who began using drugs to avoid dealing with life on what then constituted life on life terms when he was 11. He has now been clean for two years and is currently in a residential treatment program. He has been living out the script of someone who is the son of an alcoholic and who is the various diagnosis he has been given. His diagnosis includes social anxiety, depression and sleep disorder. His life has often been dictated by the truths he learns about himself and how he learned to survive. His thought process has led him on a path of weakness, hopeless and self-destruction. Is this because of the depression and the social anxiety or are the symptoms of those diagnosis a result of his belief system about himself. Some of this behavior is typical for a 19-year-old even without his particular history. He clearly needs to be treated with love and respect. Expecting him to behave as a 19-year-old adult is respectful. Expecting him to behave as an adult who is ready to take complete responsibility for his life is not loving, respectful or realistic. In some ways, he is still a very young person who thinks like a 11-year-old – the age he started using. In other ways, he is an exceptionally bright, thoughtful young man.
Guidance, parenting, and mentoring requires a careful mixture of challenge, love, understanding and an acceptance of a person’s need to discover their own truths.
With each person, it is important to set realistic, practical goals. I also remind myself to remember that what works for one may not work for another. Assigning labels such as co-dependence or tough love may not be very helpful. It is clear that change requires a certain level of discomfort. That discomfort may come from the knowledge that I am not all I want to be or can be. It may come from knowing I do not want to be in jail or do not want to love my family or my job. For others, the greatest discomfort may be confronting the fear of failing. For these individuals going to an institution may be the least uncomfortable thing that can happen.
There is much we do not know about change or how to motivate and help ourselves and others to change. If indeed tough love works with some it is because it is clear that the emphasis is on love(compassion and not on tough. My experience is that it is easy for all of us to fall into the trap of being so frustrated with the behavior of another that we take action because we are angry and not because we want to help. We may say we are practicing tough love, but in reality, we are just angry and our using our power to disengage from the person. I am not sure that this is ever helpful. Yet there might be those people who will get better just to prove one is wrong!
Treating someone as a helpless child can also be an “easy” way out for the family member or the helping professional who is exhausted from dealing with addiction or a mental illness. Co-dependence like tough love may be more about my own level of frustration and anger than about the desire to help.
The bottom line for me is to me to:
- Be very careful with labels.
- Do whatever I do with love and not because I am angry or frustrated.
Written October 11, 2017
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