Tough Love Approach to Addiction: Does It Work or Doesn’t It?

WHAT IS THE TOUGH LOVE APPROACH TO ADDICTION?

The tough love approach to addiction treatment gained popularity several years ago, and does still have its adherents today. The essence of tough love with respect to addiction is a no-holds-barred and forceful approach that may seem harsh, unloving and uncompromising.

Merriam-Webster’s online dictionary defines tough love as: “love or affectionate concern expressed in a stern or unsentimental manner (as through discipline) especially to promote responsible behavior.” Collins English dictionary says tough love is “the practice of being very strict with a relative or friend who has an addiction or other problem in order to help them overcome the problem.

Based on popular advice in the late 1960s, some parents believed the tough love approach was the only way to deal with recalcitrant children, kids who always got into trouble, didn’t listen, acted in rebellious and disrespectful ways. The kids who stole, told lies, caused deliberate harm to their peers, failed in school, participated in gangs and other illegal activity, often engaged in drug and alcohol abuse as part of their childhood existence. This created unending strife in the household, contributing to a downward spiral in the overall quality of family life. The parents believed that maintaining a united, determined and forceful approach to raising their child was the best way to turn things around.

The tough love approach to addiction was an outgrowth of this concept. The thought was, if the individual who’s addicted to alcohol or drugs, and/or a co-occurring disorder cannot and will not admit they have a problem and refuses treatment, physically forcing them into a rehab facility provided the only viable solution. Many times, addiction traced back to early experimentation in adolescence with alcohol or marijuana, stealing prescription drugs from parents or others, progressing to harder, illicit substances such as heroin, methamphetamine, cocaine, and hallucinogens.

Tough love may, however, be the only way for some addicts to get into treatment. Having rejected all previous overtures and offers of help, falling deeper and deeper into despair, suffering tremendous negative consequences and nearly giving up on life, the lifeline of tough love might just work.

Some states are considering mandatory treatment by means of involuntary commitment statutes for those who abuse opioids. New Hampshire, Pennsylvania, and the state of Washington have current bills proposed that would amend their current involuntary commitment laws for mental illness to include “ingestion of opioid substances.”. While not tough love, per se, mandatory treatment is another way to force treatment. With opioid addiction and abuse at epidemic levels in the U.S., this approach is one way to combat it.

Then, again, it might not. The person who feels forced into treatment may harbor a great deal of resentment toward loved ones and family members he or she holds responsible for sending them away. The progress that could be made in treatment may become stalled or worse, not happen at all. Rather than remain in treatment, the addict may choose to leave, thus, jettisoning his or her chances at an effective recovery.

PROS OF TOUGH LOVE APPROACH TO ADDICTION

The inevitability of an addicted loved one’s continued self-destruction is a powerful motivation for the tough love approach.

• There’s no guesswork involved. Getting the loved one into treatment is not a matter of acceptance, it’s mandatory, as far as the responsible parties (spouse, other loved ones and family members) are concerned.
• Once the loved one is off in treatment, the rest of the family can breathe a sigh of relief. They have no further responsibility in the matter.
• When the loved one is off in the treatment center, the family and loved ones can begin to pick up the pieces at home. There’s a sense of peace and tranquility, although nothing in the home may have changed.
• Only professionals can effectively deal with the outbursts, physical and mental damage brought on by addiction. It’s better he or she is where they can get the help they need. Loved ones and family members can’t provide this.
• All of life has consequences. Every person, no matter their age, must be held accountable for their actions. There are no acceptable excuses and delays to going in for treatment are not tolerated.

CONS OF TOUGH LOVE APPROACH TO ADDICTION

If tough love really worked well as an effective approach to addiction, it would be surely widely popular, touted in research and acclaimed by respected organizations such as the National Institute on Drug Abuse (NIDA), National Institute on Alcohol Abuse and Alcoholism (NIAAA), and others.

On the contrary, studies show that nurturing, supportive and loving treatment and care is a much more effective approach to healing from addiction.

• Connection is a critically important part of the healing process in recovery. When an individual feels alienated, isolated and abandoned by loved ones and family members, he or she desperately needs connection – with others in recovery, with treatment staff, and participants in self-help and support groups.
• Some addicts will absolutely reject tough love. This is especially true if loved ones and family members become disrespectful, talk in a rude and loud manner, stop showing love and compassion – all to act tough and insist on the addict abiding by strict rules and suffering the consequences for infractions.
• A gentler approach, showing empathy and compassion, being inclusive and welcoming, generally produces more positive recovery outcomes.
• Family members and loved ones who participate in family programs at the same time as their loved one receives treatment can learn much-needed skills in interpersonal communications, how to assist and support the loved one on his or her return home, how to be firm and loving and encourage positive goals.
• Being firm and loving while still providing support and encouragement for the addict in recovery combines the best of tough love and a more loving, supporting approach to addiction. Here again, adequate training in how to deal with the recovering addict is essential, not only in the language used, but also how to help the recovering individual manage everyday situations likely to trigger a relapse.

Bottom line: When addiction causes increasingly negative consequences, not only to the addict but also his or her family, it’s clear that professional help is needed. Navigating the fine line between being overly tough and sufficiently caring and supportive is a delicate, emotional experience, yet it’s one that offers the most promise for a hopeful outcome for the addict in recovery.

Sources:

Medscape, “States Consider Mandatory Treatment for Opioid Abusers.” Retrieved March 29, 2017

National Institute on Alcohol Abuse and Alcoholism. Retrieved March 29, 2017 from http://www.niaaa.nih.gov/

Psychology Today, “Stop Enabling Your Addicted Adult Child.” Retrieved March 29, 2017

The Fix, “Tough Love Doesn’t Work: A New Approach to Helping Addicts.” Retrieved March 29, 2017