There is an excellent description of a war veteran in Bessel van der Kolk’s book, The Body Keeps the Score. This Vietnam veteran was suffering from PTSD’s hallmark symptoms: nightmares, flashbacks, insomnia, and bouts of rage and depression. When the professionals discovered a prescription medication that could help him, he returned and announced that he did not take the medicine. Exasperated, the psychiatrist asked why. The war vet replied, “I realized that if I take the pills and the nightmares go away, I will have abandoned my friends, and their deaths will have been in vain. I need to be a living memorial to my friends who died in Vietnam.”
About the vet’s situation, van der Kolk wrote, “His loyalty to the dead was keeping him from living his own life.”
I have heard similar statements made about loved ones of addicts and chronically ill individuals. Most often, these statements suggest that loved ones, especially spouses and partners, are so focused on saving/controlling/fixing the addict that they’ve forgotten about themselves and their own lives. Then they are pathologized with the ‘codependent’ label.
Today, no one would dare pathologize van der Kolk’s suffering war veteran by labeling him as codependent. But for loved ones of addicts it’s a different story. Partners and family members of addicts have been in the trenches fighting horrific battles, often for decades. And there is no commander to guide them, no comrades to stand watch while they rest, no end in sight. No one is providing them with barracks to sleep in, there is no cook, no pay, no benefits. But still they make this sacrifice. And rather than honoring them, we often stigmatize them as enmeshed, enabling, and codependent.
Can we remove stigma and empower loved ones of addicts at the same time? Yes, of course we can. But we need to understand that distinctions tend to create different climates. A ‘bad’ label (like ‘codependent’) tends to be restrictive, and people tend to close in and become defensive. On the other hand, a ‘good’ label (like ‘prodependent’) tends to free people. They become more open and expansive. They are more likely to generate new ideas and actions, and to be more open to new or different ideas. (See: Becoming Solution-Focused in Brief Therapy.)
Inevitably, when I share this idea with colleagues, I hear, “Well, what about the partners and parents who are enabling? They are only making things worse.” While it is true that loved ones of addicts can love in ways that delay the consequences of addiction (and therefore the likelihood of the addict hitting bottom and moving forward into recovery), the ultimate responsibility for sobriety and recovery lies with the addict and the addict alone.
Loved ones’ well-meaning attempts to help the addict do not point to a mental disorder or sick thinking or a personality disorder. Rather, these efforts reveal a deep loyalty, a fear for personal and relational safety, and a hope that keeps them engaged in a situation that appears hopeless. The simple truth is that we need more people in the world who are willing to love others so selflessly and deeply, however imperfect those others may be.
That said, as therapists, we may at times need to help these loving people learn and implement more effective ways of assisting their struggling loved ones. By helping them with guidelines and realistic limitations, we also help them find peace and comfort in knowing that they are doing all they can to help, but sometimes that might not be enough because change has to happen within the addict. Change cannot be forced upon the addict, no matter how much we want to help them.
So let’s stop sending messages that partners should ‘allow consequences’ as a way of bringing about change. Let’s stop telling partners that they have the power to enable or not enable and that their choices determine whether the addict will change. At the end of the day, there is nothing a loved one does or does not do that causes the addict to change or not change.
Proponents of codependency often send a double message with which loved ones of the addict can never succeed. If they don’t set boundaries, they are enabling, which has the power to keep the addict from healing, and if they do set boundaries, they are trying to control and manipulate the addict, thus prohibiting the addict from healing and changing.
Rather than sending this lose-lose message of codependency, let’s applaud loved ones for their tenacity, resilience, creative problem solving, hope, and endurance. Let’s empower them with prodependent resources, education, and support systems that nourish rather than deplete. Let’s not define them as weak, manipulative, or irrational. Let’s stop sending mixed messages about their role and power in the addict’s life, instead providing them with clear directives and practical tips for finding light and life again. Let’s help them remember how beautiful life can be.
Removing the stigma of loving an addict and empowering the partner to love better are not mutually exclusive. To my colleagues I say, we can stop dehumanizing and pathologizing loved ones of addicts while guiding them to beauty, wholeness, and wellbeing. To those brave loved ones I say, thank you for continuing to love and sacrifice on behalf of those suffering through addiction and chronic illnesses. You are heroes. And there is hope and healing in store for you.