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In a stereotypical family, parents provide their children with unconditional and overwhelming love. Parents accept their children just as they are, and provide those children with a safe place to land if they make mistakes. The door is always open to the child, no matter what that child may do. While this method might work well for parents of young children, parents of teens often discover that unconditional love can seem like an open invitation to drug use and alcoholism.
When stressed parents head online to search for advice, they may find that their parenting style is blamed for these addictions. As just one example, a study from Demos compared parenting styles in thousands of families, and then determined the likelihood of alcohol addiction among the children. Researchers found that children of parents who performed so-called “tough love” parenting produced children who were unlikely to develop problems with alcohol. Parents at the other end of the spectrum were 30 percent more likely to produce children with alcohol problems. In short, a soft parenting approach led to addiction in kids.
Some intervention specialists take this idea one step further. Instead of encouraging parents and families to apply tough love to prevent addiction, they suggest tough love can turn around people who are already addicted. These specialists use tough love principals in interventions, laying out consequences for the behavior that are clear and direct, and then steering the addict to make the right choice or face those consequences head on. The door is no longer open if the addict will not change. It’s a radical adjustment for some families to make, and not all families agree that it is the best approach to take.
The term “tough love” was first used in 1976, but it wasn’t applied to an addiction model until the 1980s, when David and Phyllis York wrote an influential book about the addiction and rehabilitation of their daughter. In this book, Toughlove, the authors outlined a rather harsh view of rehabilitation techniques parents should use with their addicted children. The child was told that drinking and drug use were simply unacceptable, and the child should enter a treatment program. If the child refused to comply, the child was asked to leave the home. Parents were told to stand firm to this model no matter what, and encourage the child to explore the negative consequences of noncompliance. The thinking here was that the parent was in control of the household, and the child was in control of the behavior. If the child wouldn’t accept the rules of the house, the child wasn’t allowed to stay in the house. When faced with that choice, the thinking went, the child would pick sobriety. Therapist began to apply this approach with adults as well as children and, over time, the tough love approach has been softened and refined. Aspects of tough love are now often included in intervention programs.
In a standard intervention, the intervention specialist meets with the family to talk about the addict’s behavior and the effect that behavior has on the family. Then, the family meets with the addict in a surprise meeting, and the family confronts the addict with the behavior. In the tough love approach, the family also outlines consequences that will occur if the addict doesn’t change.
Consequences can vary from the mild to the severe, depending on the level of the addiction and the damage it is causing to the family. For example, if the addict will not change, the family might:
Take legal custody of the addict’s children.
Refuse to provide any sort of financial assistance.
Ask the addict to leave the home.
Refuse to provide bail money or legal assistance.
Some intervention specialists ask family members to write consequences down, and avoid sharing those consequences during the intervention. The consequences are turned into a “bottom line” that can be shared with the addict during the recovery process. If the addict becomes tempted to stray, the intervention specialist can share the consequences and provide enough of a shock to keep the addict on the proper path.
Other intervention specialists consider the tough love approach a method used to protect the family from damage. The consequences the family outlines may not help the addict change, but they can keep the addict’s children and other family members from witnessing the abuse and suffering the consequences. The addict is shown the consequences, refuses to make changes and the family moves on without the addict. This may be particularly helpful if the addict is abusive, impulsive or liable to threaten the health and safety of the family members. The intervention specialist works to define clear consequences with the family, and helps the family put those consequences in place when the addict will not comply.
Not all interventions require this level of threat. In fact, one company states that only 10 percent of clients need this level of intervention. Some addicts will be compelled to change when they listen to a litany of stories about the way their addiction impacts the people they love. But there are specific benefits that the tough love intervention model can provide that other methods may not be able to match. For example, in a tough love approach:
Boundaries are clear. Some addicts respond well when they know just how much they stand to lose by their addictive behavior. Keeping those consequences in mind can help motivate them to change.
Families are protected and empowered. If the addict simply will not change, the family members can move forward alone and focus on their own health.
Power is shifted. Many families feel controlled by the addiction. By defining the problem and outlining what they will do, they empower themselves to fight.
It’s dramatic. Some addicts don’t respond to stories of love and compassion. When they hear a litany of real, permanent, harsh consequences, it can break through the armor of addiction and allow them to listen and change.
The tough love intervention approach may have fans, but the approach also has detractors. In fact, some critics say that the very definition of addiction would rule out the effectiveness of a tough love intervention.
The American Society of Addiction Medicine released a new definition of addiction in April of 2011. In this definition, addiction is defined as a chronic brain disease that changes the way that the brain functions at a molecular level. Where prior definitions focused on behaviors of an addict and choices an addict made, this definition stresses that behaviors come about as a result of changes in the brain. The implication is that an addict cannot simply change behavior from one day to another. The addict can’t simply decide to stop the behavior, no matter what the consequences are, due to those changes in the brain.
Apply this definition to the tough love intervention model and the crux of the tough love criticism becomes clear. In the tough love model, the addict must change or else terrible consequences occur. If the addict relapses, the consequences occur. The model doesn’t seem to use a supportive, kind approach that recognizes that addiction is a disease, so relapse is likely and the family must stay supportive.
A study of a similar condition seems to back up this criticism. This study, conducted by BMC Public Health, polled obese people and asked about various methods used to encourage them to change their eating habits and develop a healthy lifestyle. Respondents stated that they were more likely to respond to methods that left them feeling supported and valuable, rather than stigmatized or shamed. In short, they were more likely to change their behavior if they felt the message was given in an empowering way. This study implies that tough love approaches might not work for chronic diseases, especially if the addict leaves the conversation feeling attacked and shamed.
A Takeaway Message
Every addict and every addiction is a bit different, and some methods that work for one addict simply do not work for other addicts. Reading through the research does make one point clear, however. Families truly should hire an intervention specialist to help schedule, structure, define and administer a tough love intervention.
Families that have been subjected to years of addictive behavior may have years of pent-up hostility just waiting to explode. It would be easy for these families to skip ahead in an intervention and move directly into threats and consequences. When an addicted person is subjected to this sort of conversation, hostilities can develop and the family can become further fractured. An intervention specialist can help the family develop consequences, and then ensure that the family presents those consequences in a loving and supportive way. The addict is more likely to listen when he or she isn’t being attacked.
In addition, a tough love intervention should end with some sort of call to therapy. Simply asking an addict to change, without providing any sort of tools to help the addict change, is underestimating the strength of the addiction. It’s unlikely the addict can simply overcome the disease without outside help. An intervention specialist can provide that outside help through one-on-one counseling or group counseling sessions. According to an article presented in Counselor Magazine, 85 percent of addicts will accept outside help at the end of an intervention, no matter what intervention method is used, so it must be included in any planning the family does.