|Sponsored by the HealthcareTrainingInstitute.org providing Quality Education since 1979|
On the last track, we discussed we have discussed the characteristics of a family entering recovery. We also discussed the three key steps family members of addicts make as they become ready to enter recovery. These three steps are, accepting they cannot control the course or consequences of the addiction, realizing that family interactions have been controlled by the addictive process, and finding out that addiction is an illness.
On this track, we will discuss the label of "enabler", and ways in which family members can reframe their role to better help their own health and that of the addict.
As you are aware, the term enabler first entered the therapeutic vocabulary about 25 years ago, when the recovery group movement was still fairly new, and originally meant specifically ‘someone who passively or actively made it possible for an addicted person to drink or use drugs’. More recently, I have observed that the term enabler is broadly used to covey the idea that addicts are powerless over their behavior, and thus are dependent on others to manage their lives for them.
Transfer of Blame
I find that sometimes, the addicted family member picks up on this concept, and come to believe that anyone who does not crack the whip over him or her is an enabler, and jointly responsible for the continued addiction.
My client Gary was in a similar position with his wife, Joanne, who had been addicted to tranquilizers for two years. Joanne, 32, had been unable to hold a job for more than six months at a time, and had been hospitalized several times, and jailed twice. Gary would invariably bail her out and pay her bills, and plead with Joanne to get help, but his pleas always turned in to ugly arguments. Gary worked full time while balancing the needs of the couple’s three young children, and a significant portion of his paychecks went in to filling Joanne’s tranquilizer addiction.
I observed that Gary had fallen in to a pattern of apologizing in public for Joanne’s odd behavior and outright rudeness, and calling her employers, when she had them, to make excuses for her absences. When I asked Gary about his pattern, he stated, "I love Joanne! I put up with it, because there’s a chance that our family can remain together."
Why Labeling as 'Enabler' is Counterproductive
Joanne stated, "I married a real sweet, laid-back guy. But now he’s insufferable! I only started using tranquilizers because we kept having more and more problems. God… Gary is just such a pain now! All he wants is to deprive me of the one thing that keeps me going and makes me happy!" Clearly, Joanne perceives Gary’s anti-addiction attitude as picking on her. She remained determined to keep using tranquilizers, despite Gary’s ‘immense overreaction’. Joanne went on to state, "look, I’ve tried my hardest to reason with Gary. If he decides to leave, so be it. It’s not my fault if he can’t cut it."
I find that to label Gary an enabler in this case is counterproductive. Would you agree that labeling Gary in this way also turns him into an identified patient, when in fact he is the non addicted partner in the relationship. Although Gary apologizes and compensates for Joanne’s addictive behavior, he has done his best to keep all of his family safe and at least partly functional.
In this case, I believe applying an illness label may undermine Gary’s motivation to heal his family, and trap him in a shame spiral. As you can see, Gary is already experiencing significant feelings of guilt and self doubt. Traditional codependency counseling would have Gary withdraw from Joanne, and spiritually compensate for the loss of the love of his life. If Joanne ‘came to her senses’ in a manner acceptable to this form of treatment, then Gary could welcome her into his new, compensated lifestyle.
Gary stated, "Well, I am a very warm and loving person. I’m a great guy. I trust myself." Are you treating a client like Gary who is struggling with guilt, who might benefit from a positive affirmation exercise? Would playing this track be beneficial to your Gary?
On this track, we have discussed the label of "enabler", and ways in which family members can reframe their role to better help their own health and that of the addict.
On the next track we will discuss the ‘collapse’ stage of recovery. In my experience, the three most important points to consider when discussing the collapse stage are, letting go of long-standing routines and rituals, letting go of old attitudes and behaviors, and the fear of ‘walking backwards’.
Peer-Reviewed Journal Article References:
Others who bought this Addictions/Substance Abuse Course