Dwight Hurst, CMHC: Welcome back to our podcast to answer your questions on addiction, recovery and mental health by Waismann Method Opioid Treatment specialists. I’m your co-host, Dwight Hurst. I’m joined as always today by my fellow hosts Clare Waismann and David Livingston. This episode is actually the first part of a two-part conversation we had in answering the question: “What Constitutes Enabling?”
Dwight Hurst, CMHC: Enabling is a big concept in the world of addiction and treatment. And we had a listener who asked us a question, by the way, thank you to Meg, our listener, all about what is enablement, how do we define it and how do we stay away from it. Part one of this conversation is going to focus on the most commonly discussed type of enabling, which applies to the parent-child relationship, particularly parents of adult children. It’s often what’s focused on.
Dwight Hurst, CMHC: The second part, which will be the next episode is focused more on enabling or not enabling or what to do instead of enabling in our own adult relationships, particularly partnered or romantic partner relationships. Let’s get into it.
Dwight Hurst, CMHC: So our question today comes from Meg, and what she wanted to know is what does it mean to enable a loved one with an addiction? That’s something we hear about a lot. People will say, I’ve known lots of people who say when they try to help their loved one, they are told that they’re enabling. There’s a lot of question over what is and what isn’t enabling. And so I think this is a really pertinent question. So what’s what’s the first reaction to this?
David Livingston, LMFT: You want to start, Clare?
Clare Waismann, RAS/SUDCC: No, I’m going to let you start with that.
David Livingston, LMFT: Ok, “How do you enable someone?” is basically what you’re asking?
Dwight Hurst, CMHC: Yeah. We kind of how to we want to help people enable more… No, just kidding.
David Livingston, LMFT: Meaning, “When are you enabling and when are you not?”
Dwight Hurst, CMHC: Exactly. I think that’s a good way to attack it because sometimes I find that people are told that they’re enabling and a lot of times they’ll ask their therapist or someone else, they’ll say, what does that mean?
David Livingston, LMFT: I guess the first thing I would say is like everything we talk about here and maybe it’s why we’re talking about all these subjects. You have to think it all through and it can get complex because it depends on situationally, depends on a lot of things, and it depends on the person, depends on where they’re headed. But and in essence, you do not want to enable anything that is unhealthy or destructive.
David Livingston, LMFT: OK, so is in general, OK, now that gets, there’s a lot of murky territory when you get into that, sometimes, you know, some people will say, “Well, you’re using you can’t stay at my house… You can’t do that. You have to do this.” Sometimes that actually just throws people into panic or dangerous situations. And they say, “Well, someone told me that if I let you stay here or whatever, I’m enabling you.” So all of that gets there’s a lot of gray area and you have to really pass out situationally because the goal is to help the person get into a better place. So from my perspective, you have to really think through what is going to help them. And part of that is a conversation with them. If they’re just using you in a way that is furthering a lifestyle in a way that that isn’t helping them, you know, that needs to be considered.
David Livingston, LMFT: And so it’s, and I’m speaking to it broadly because it’s hard to say specifically without kind of the situation. But in general, you want to support things that are healthy. Someone says, “Look, I need to stay here and I need help getting off this. And I’m going to get into a detox. Can you help me get from here to there?” And you’re like, “Oh, my God, I’d be enabling you. That’s a brutal situation. And I’ve talked to parents and people who’ve done that. And I think you have to be really clear on what the objective is. And, you know, there are other options now, too. Like you can go to doctors and you can get help with medications to get you until you can get to a detox. So I think in general, you’ve got to think it all through. You want to get people out of any situation that’s dangerous, you know, in terms of overdose, in terms of the law or doing something that’s illegal. And so those are the things that you want to find other ways around and not promote, in general.
Dwight Hurst, CMHC: There’s a feeling of what is it that I’m enabling because enabling, but like what’s the difference between enabling and empowering? And I think what you’re saying is the principle is enable good behavior, don’t enable bad behavior. To me, that’s the underlying underpinning of how to help someone like, you know, because there might be times where staying at my house is not safe for me, not safe even for them or not safe for other people. If I have a child and they are giving their siblings in danger, they’re bringing weird people around the house and they’re not willing to respect that. That’s a very different situation than if they’re using it as a safe base of operations to schedule treatment or apply for jobs or follow through on their probation, whatever it is. That’s a very that’s then you’re enabling someone to have good behavior, which we usually think of as empowering. Right?
David Livingston, LMFT: That’s it. That’s those are great examples. That’s it. That’s right. So the intention is critical, like where you’re headed and you know, and genuinely am I helping you get to a healthier place, you know, so that that’s the main way I think about it. But there’s a lot of situations like you’re bringing up that have to get parsed.
Dwight Hurst, CMHC: Yeah, I think trying to approach it with a principle-based decision is always more difficult. It’s easier to have a flat catchall answer like don’t do it. Then like you said, people will say, well, I’ve been told if I give anyone money, then I’m enabling them. But yet I’ve known a lot of people that will, you know, cautiously and with discussion, maybe help pay a bill directly to a creditor if they can afford it. And it helps someone to, you know, and if it helps someone to not get lost their child or someone to not get hopeless or despondent, but it kind of falls down to would you do that anyway? Right. And if you have a relationship with your kid where boy, you know, they’re going to lose their apartment if they don’t get a little help this month, maybe I’ll drop a check off directly to the office. But is that enabling them? Well, it depends, doesn’t it?
David Livingston, LMFT: It does and it does and, you know, it’s a dialog, you know, if I do this, then where are you headed? And then here’s the course forward. If we’re going to if I’m if you want my support, here’s what we’re going to do right here, OK? You’ve got to get into treatment. We’ve got to do this. We’ve got to do that. And I’ll help you with that if you can and if you want to. And so there’s no it also depends on how the person feels and what the relationship is. And there’s all kinds of factors. It’s a hard topic to discuss generally. And I think your examples were good. So but in general, if you can and if you feel inclined to help someone towards, you know, getting better, that that’s good, you know, assuming they’re sincere.
Clare Waismann, RAS/SUDCC: I hear what David is saying. And I think the major word here is “intent”. So if you are helping someone with a plan to achieve a healthier place and obviously has to be in the parameters of safety, yours and everybody that is involved in that decision, I think is usually but not generally a good option. But there’s got to be a plan. You can’t just say, oh, yeah, you can sleep here today or I’ll pay this bill for you today without what’s going to happen tomorrow because another bill is going to come or another day’s coming as well. So, OK, I will do this for you. But what is our plan, how we’re going to do today so we don’t have to go through this next week again. So I think there’s a bargaining space over there where you can be helpful and you can also create, you know, a plan where the person also believes that they have some control in their future, some say, on what they’re going to do. So I think it can be a positive. You can change that, need that request to actually a positive step towards a healthier space.
Dwight Hurst, CMHC: It’s doing it purposefully, really trying to say, what’s my goal and am I moving towards my goal?
Clare Waismann, RAS/SUDCC: Correct, yeah, correct.
David Livingston, LMFT: And one of the things that gets people better is strong, healthy commitments. And so if I’m making a commitment towards somebody and they’re doing it, that’s a powerful thing. And honestly, the idea that you have to do it, you have to do it. You have to get sober for yourself. I don’t believe one hundred percent. I think it’s great to do things for other people, too, and to feel grateful for their help and their care. You also you can’t be just doing it for that reason. That won’t carry you through. You have to be doing it because you want to as well. But when all those things line up, it’s actually a stronger commitment. And actually, I think it creates more motivation, a stronger sense of support. There’s a feeling of connectivity that helps carry things through. I think it’s I think people stronger when it happens that way.
Dwight Hurst, CMHC: That’s like the dirty little secret sometimes of that principle. People say you got to do it for yourself or else or else or else or else. And you’re talking about that healthy sort of interdependence, I think, where you’re saying, like, actually, you know, there’s a little if it really wasn’t for anyone else and my commitment to them, I might actually be less likely. So there’s a balance there. I certainly don’t want to say I’m doing it 100 percent for my partner, because then if what if we break up or if they get mad at me or something and I can blame them for relapse? I, I think that’s the sentiment they say to be careful of, really. But really, I’ve found that without some commitment, at least to the world around us, we really don’t want to get sober because why would I do that?
David Livingston, LMFT: That’s it. That’s right. It’s it should be everything. It’s like I hear people who are saying that you have to love yourself first before anything can happen. That goes against almost every developmental process I’ve ever learned that it really comes from you know, the way people develop is through mirroring from the beginning of our lives. It’s through good mirroring. It’s through being loved and cared about and taking care of and supported. Now, as you get older, you have to internalize that. You do have to carry that for yourself. You have to begin to create a healthier sense of independence, make healthy decisions and be responsible for yourself. But the way to get there and this goes on forever. It’s it goes back and forth – the more loved and supported and taken care of we are by other people, the more we have an opportunity to internalize it, feel valuable, feel that and hold on to that and then carry that forward and then give it back to other people, too. That’s how development really works. It’s and so this, you know, and by the way, that’s part of what a treatment is about, you know. And when I think of Domus and what we do here in our whole process, the main thing I think of is really helping people feel cared about, respected, understood, leaving here, feeling like they had an experience of people who looked after them where you cared about them, and that fortifies people. So that’s really what therapy is about ultimately. And many ways and treatments significantly should be about.
Dwight Hurst, CMHC: It’s interesting when you’re looking at things in that nuanced way, there’s almost always something that you can do. I find that one of the reasons people fall back into a trap of enabling or of helping without a plan is because they’re told to enable, don’t enable, don’t enable. And they interpret that as don’t do anything and they can’t bring themselves to most of us can’t bring ourselves to just not do anything for my kid. And so we don’t do it smart then because they feel like, well, I’m already breaking the rules and you know, you know, so I’ll just whatever just stay here with no real plan or agenda or whatever. At least that’s I see that a lot where people feel like it’s all or nothing. And so they’re like, well, if I’m not comfortable completely cutting off my kid, then I’m not thinking in terms of what are my boundaries, at least that I see that.
Clare Waismann, RAS/SUDCC: I see that a lot, actually more often than I would like to see. I think people are misguided by people that work in the field but really have no training and is very easy for them to say, no, don’t answer the calls. Don’t let them come in. Don’t. And again, they generalize a situation that they are really not knowledgeable about. And that puts people at tremendous risk, especially nowadays, that the drugs out there are so dangerous. So. Yeah, I see that quite often, and sometimes it’s scary.
Dwight Hurst, CMHC: Yeah, I’ve known of a couple of people who, for example, their experience with their child, their adult child might be “If you’re in my house, you’re going to steal.” Or, you know, “We’ve had bad experiences before, so I can’t let you stay here.” But they’ll put together maybe a little packet of information so that if you show up on the doorstep, “Here’s hey, you know, here’s you know, where the shelter is.” Right? “Here’s the thing. And you know what? Maybe I’ll drive you over. But yeah. Gosh, you can’t stay here tonight because then you’ll refuse to leave tomorrow. That’s just what’s happened before. But here’s something.” And maybe they’ll throw it on the ground or maybe, you know, whatever. But it’s sometimes a little something that someone can do can feel empowering to the individual to say, hey, you know, “I’ve done something.”
Clare Waismann, RAS/SUDCC: Of course, and I think every situation is unique, you know, it’s you can’t make one decision and say to all parents to follow that at that time, they can have some professional support throughout their decisions because it’s very, very exhausting for parents to go through this. There’s a lot of manipulation. There’s a lot of a misunderstanding of the condition. There’s a lot of, again, bad guidance from people. So I think it’s important for them to have some kind of professional support, not just the patient, but the parents as well. But, you know, every single… It is a different day and sometimes a person that yesterday was not willing something happened on that day and today they are. So they know it could open a door for something great, for something positive. So you cannot assess an event before it happens.
David Livingston, LMFT: I think that’s a great point. Maybe to look at the other side of enabling. So the danger would be that you can’t bear the tension of telling someone “no”, you can’t bear their distress or whatever pressure they put on you to try to do something. You don’t want to bear that distress that’s coming from them. And so I think the way to handle that, which is kind of what you’re both talking about, is, you know, in the end, the way I try to handle it is I have a discussion about if I need to say we can’t do that or we’re not going to do that. And here’s why. And I go through the whole process and I explain to them as clearly as I possibly can why it’s not in their best interest. And even though they may not like the answer and they may feel upset or, you know, because you’re saying no to something, what happens is, is they actually still thought about they feel like you cared enough to explain to them a rationale. You explain that you have thought it through and here’s why you’re saying “no”. And here’s the danger and what they’re asking for and here’s why you don’t want to do it. And then you also help think about other solutions to their needs. Right? What happens is they feel they feel cared about, even though you’re saying “no’, I can’t do that or I don’t think it’s the best thing for you. And they feel like you’re still in process with them, that you’re not just saying no one’s sending them off. So there’s a process that’s continued through it and there’s a way you stay connected. And also then it actually strengthens the relationship because they feel like you can bear the tension of parts of themselves that they are having trouble with. Like you can hang in there with them when you meet and hopefully come up with a creative solution that is good for them. So that I think that’s the best way I know how to handle enabling.
Dwight Hurst, CMHC: We’re going to call it there for today. Really grateful for those of you who have been able to join us, looking forward to sharing with you next week the second part of this same discussion where we will be talking about enablement as it applies to romantic partners and relationships. A podcast to answer your questions on addiction, recovery and mental health is presented by the Waismann Method Opioid Treatment Specialists and is hosted by Clare Waismann, David Livingston and Dwight Hurst. If you want to learn more about the treatments that we offer through Waismann Method, or just learn more about treatment and addiction in general, head over to opiates.com. to learn more about the Waismann Method. You can also follow us on Twitter @opiates Our music is the song Medical by Clean Mind. Sounds glad to be with you every week and want to encourage you to keep asking questions about these things and about everything, because as always, if you ask questions, you’re more likely to find answers. And if you find answers, you can find hope. We’ll see you next time on the Waismann Method podcast.