Monday, August 22, 2016

Enabling? Forget it!

The views in this blog are my own and not necessarily the views of my employer or any educational organization I may be affiliated with. But they probably should be.

"Enabler" is one of those words with people use when they want to sound like the know something about addiction, but both in and out of the field it is applied to so many different behaviors and situation that it is practically meaningless. In my experience the concept of "enabling" is usually introduced into the conversation about a difficult case just as the team is preparing itself to discharge the client or to use the threat of discharge to coerce the client into a higher level of care. In public it's most often attached to the parent or loved one of someone struggling with addiction but they never say exactly what they mean and I suspect they don't really know. I have NEVER seen anyone helped by this concept being introduced. I've never seen a case turned around by addressing "enabling." The reason may be that it is only introduced after the team has given up and is looking for a way to get rid of the living reminder of that failure.

So what is an enabler? Tell us Internet!


  1. a person or thing that makes something possible.
    "the people who run these workshops are crime enablers"

    • a person who encourages or enables negative or self-destructive behavior in another.
      "he criticized her role as an enabler in her husband's pathological womanizing"

So in the business of recovery an enabler is something, a person, policy, or institution, that makes it possible for a person to use drugs. This sounds like a terrible thing. This begs many questions but the first that comes to mind is this. How are we making it possible for them to do drugs? Do we really have that power? In the case of the treatment centers who floated this concept as a reason why it might be in the client's best interest to be kicked out of the program, didn't the client use before they came to us? Then how did we suddenly take on this responsibility? We are not making it possible for the client to use drugs and I offer as evidence that most and possibly all of the clients discharge in in order to stop enabling in my experience continued using as much or more than they did before coming to us. It seems we aren't so powerful after all. 

But it is rare for treatment centers to be called enablers, the term is usually reserved for the parents and loved ones of people struggling with addiction and it is to them that it does the most harm. It is hard to watch someone you love struggle with addiction. Those who have to will at best find themselves awake with worry night after night and at worst will suffer profound trauma. The will watch the person they love go through ups and downs. They may experience numerous heart rending disappointments as promising starts turn to relapse again and again. They may have to bury their child. It is unbelievably cruel to tell them at any point along the way that it is their fault, that they could have stopped it from happening if only the hadn't been so kind.

Parents and loved ones have, like treatment centers, do not have the power to make it possible to use. They are not encouraging the behavior unless they are literally telling their children to use. But so I'm not at risk of being as vague as those who promote the concept I want to give some specific actions/behaviors that ate definitely NOT enabling. 

-Providing your loved one with food IS NOT enabling 
-Allowing your loved one to live in a safe place after a relapse IS NOT enabling 
-Giving your loved one a little money even when you suspect they are using IS NOT enabling 
-Telling your loved one "I love you no matter what. I love you if you relapse and I love you if you never use again" IS NOT enabling 

As for examples of things that definitely are enabling 

-I don't know. I'm not sure I've ever seen any

My recommendation for people with loved ones struggling with substance use is to forget they ever heard the word "enabler" and my advice to my peers in the field is to stop using it completely. Loved ones worry more about how healthy your behaviors are for you, but don't pretend you have the power to stop your child's addiction. If punishment were an effective treatment for addiction the U. S. Prison system would be the greatest treatment center in the world. It's not.

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